Provider Demographics
NPI:1912178351
Name:LONGONI, NICOLETTA (RNFA)
Entity Type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:
Last Name:LONGONI
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-754-0833
Mailing Address - Fax:301-754-0388
Practice Address - Street 1:2101 MEDICAL PARK DR
Practice Address - Street 2:SUITE 305
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-754-0833
Practice Address - Fax:301-754-0388
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR178823163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant