Provider Demographics
NPI:1063061851
Name:NEWMAN, TERESA ANN (RN)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3672 STATE ROUTE 810 S
Mailing Address - Street 2:
Mailing Address - City:KUTTAWA
Mailing Address - State:KY
Mailing Address - Zip Code:42055-6757
Mailing Address - Country:US
Mailing Address - Phone:270-908-9048
Mailing Address - Fax:270-632-4201
Practice Address - Street 1:3672 STATE ROUTE 810 S
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055-6757
Practice Address - Country:US
Practice Address - Phone:270-908-9048
Practice Address - Fax:270-632-4201
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty