Provider Demographics
NPI:1467684274
Name:LONG, DENISE (DNP, RN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:LONG
Suffix:
Gender:
Credentials:DNP, RN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PIONEER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3825
Mailing Address - Country:US
Mailing Address - Phone:609-265-5291
Mailing Address - Fax:
Practice Address - Street 1:15 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3825
Practice Address - Country:US
Practice Address - Phone:609-265-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08118700363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0486353Medicaid