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General NPI Number Information
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NPI Number | 1063144467
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Entity Type | Individual
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Provider Name | MELISSA LONG NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2022
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 85 PRESCOTT ST STE 403
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City | WORCESTER
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State | MA
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Zip | 01605-2671
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Country | US
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Telephone | 508-753-7259
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Fax |
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Provider Business Mailing Address
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Address Line | 7 GOODNOW RD
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City | PRINCETON
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State | MA
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Zip | 01541-1602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2333721
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2333721
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2333721
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License Number State | MA
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