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NPI Code Detail

MEDICARE: MR. JAMES LEROY LONGMIRE II FNP-BC

MEDICARE: MR. JAMES LEROY LONGMIRE II FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner23260TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508376393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES LEROY LONGMIRE II FNP-BC
Provider Business Mailing Address
First Line : PO BOX 773
Second Line :
City : COVINGTON
State : TN
Zip : 38019-0773
Country : US
Telephone Number : 901-833-7095
Fax Number :
Provider Business Practice Location Address
First Line : 951 COURT AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2813
Country : US
Telephone Number : 901-577-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2017
Last Update Date : 09/29/2023

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