MOLLY CATHERINE LONG N.P.
NPI 1164815379
Nurse Practitioner - Adult Health in Fort Wayne, IN

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LA2200X and a focus in Adult Health.

Active since March 12, 2015

3512 STELLHORN RD, FORT WAYNE, IN 46815(260) 483-9081(260) 483-9196 Get Directions Write a Review

NPPES record last updated: December 6, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 6, 2018, Aug 1, 2018 (2 updates tracked since 2018).

On this page

About Molly Catherine Long N.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOLLY CATHERINE LONG N.P. (NPI 1164815379) is an individual adult health provider in Fort Wayne, Indiana, licensed in Indiana (71005386A) and active in the NPI registry since March 2015. She maintains a secondary practice location in Fort Wayne.

NPPES Registry Identity

NPI1164815379

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMOLLY CATHERINE LONGCredential: N.P.

Location Address3512 STELLHORN RDFort Wayne, IN 46815-4631

Mailing AddressPo Box 392552Pittsburgh, PA 15251-9552 · (260) 483-9081 · Fax (260) 436-9662

Phone(260) 483-9081

Fax(260) 483-9196

Sole ProprietorNo

Enumeration DateMarch 12, 2015

Last NPPES UpdateDecember 6, 20182 updates tracked since enumeration

✔ NPI 1164815379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in IN · 71005386A

Also ListedRegistered NurseTaxonomy 163W00000X · License 28192221A (IN)

3512 STELLHORN RD, Fort Wayne, IN 46815

Open in Google Maps ↗

Secondary Practice Location 1

Location 17956 W Jefferson BlvdFort Wayne, IN 46804 · Phone (260) 436-2416 · Fax (260) 436-9662

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LHYRA DAWIS MAYORALGO PT

Contractor