Ms Katherine Marie Longoria, PNP, RN - Nurse Practitioner in Portage, MI

Ms Katherine Marie Longoria, PNP, RN is a Nurse Practitioner - Pediatrics based in Portage, Michigan. Ms Katherine Marie Longoria is licensed to practice in Michigan (license number 4704250766) and her current practice location is 2680 W Centre Ave, Portage, Michigan. She can be reached at her office (for appointments etc.) via phone at (269) 324-2400.

NPI number for Ms Katherine Marie Longoria is 1275887051 and her current mailing address is 2680 W Centre Ave, Portage, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275887051.

Contact Information

Ms Katherine Marie Longoria, PNP, RN
2680 W Centre Ave,
Portage, MI 49024-4828
(269) 324-2400
(269) 324-0450

Map and Direction




Provider's Profile

Full NameMs Katherine Marie Longoria
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location2680 W Centre Ave, Portage, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1275887051
  • Provider Enumeration Date: 11/01/2012
  • Last Update Date: 11/13/2020

Medical Identifiers

Medical identifiers for Ms Katherine Marie Longoria such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275887051NPI-NPPES
1275887051MedicaidMI
1801818752OtherMIBCBSM - BMG

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0200XRegistered Nurse - Pediatrics 4704250766 (Michigan)Secondary
363LP0200XNurse Practitioner - Pediatrics 4704250766 (Michigan)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Katherine Marie Longoria is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Katherine Marie Longoria, PNP, RN
2680 W Centre Ave,
Portage, MI 49024-4828

Ph: (269) 324-2400
Ms Katherine Marie Longoria, PNP, RN
2680 W Centre Ave,
Portage, MI 49024-4828

Ph: (269) 324-2400

Reviews and Comments


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Christina M Kemple,
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Practice Location: 7775 Angling Rd, Portage, MI 49024
Phone: 269-324-8670    

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