1700844149 NPI number — MRS. CAROL ANN NEWMAN PNP

Table of content: MRS. CAROL ANN NEWMAN PNP (NPI 1700844149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700844149 NPI number — MRS. CAROL ANN NEWMAN PNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWMAN
Provider First Name:
CAROL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700844149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SHAPE HCF, UNIT 21414
Provider Second Line Business Mailing Address:
BOX 215
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
EUROPE
Provider Business Mailing Address Postal Code:
AE
Provider Business Mailing Address Country Code:
BE
Provider Business Mailing Address Telephone Number:
423
Provider Business Mailing Address Fax Number:
4235918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SHAPE HCF, UNIT 21414
Provider Second Line Business Practice Location Address:
BOX 215
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
EUROPE
Provider Business Practice Location Address Postal Code:
AE
Provider Business Practice Location Address Country Code:
BE
Provider Business Practice Location Address Telephone Number:
423
Provider Business Practice Location Address Fax Number:
4235918
Provider Enumeration Date:
05/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RN113884 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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