Provider Demographics
NPI:1295265403
Name:LONG, MARGARET (CRNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1290 AUTUMNVIEW DR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-2876
Practice Address - Country:US
Practice Address - Phone:513-312-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.343778163W00000X
WARN61196467163WN0002X
OHAPRN.CNP.021705363L00000X
PASP032658363L00000X
MI4704401731363L00000X, 363LN0000X
WAAP61196532363LN0000X
NYF350549-01363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner