Provider Demographics
NPI:1023999422
Name:LONG WELLNESS COLLECTIVE LLC
Entity type:Organization
Organization Name:LONG WELLNESS COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:720-467-7942
Mailing Address - Street 1:2150 W 29TH AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3867
Mailing Address - Country:US
Mailing Address - Phone:720-467-7942
Mailing Address - Fax:
Practice Address - Street 1:2150 W 29TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3867
Practice Address - Country:US
Practice Address - Phone:720-467-7942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty