Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica Beth Long, AGNP-C

Individual provider Nurse Practitioner · NPI 1194244707

Jessica Beth Long, AGNP-C is a Nurse Practitioner in Eagle, Idaho. Qualified in 2017, 9 years ago. Practices with Riverside Primary Care Adult and Geriatric Medicine Plllp, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2017

Practice location Address checks out

420 E State St Ste 135
Eagle, ID 83616-4898
Phone: (208) 402-9956
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 56895 (ID)

Record details

NPI number1194244707
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedSeptember 14, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Riverside Primary Care Adult And Geriatric Medicine Plllp — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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