Provider Demographics
NPI:1104389444
Name:NEWILL, TOBIE JEAN
Entity type:Individual
Prefix:
First Name:TOBIE
Middle Name:JEAN
Last Name:NEWILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 ADAMY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2973
Mailing Address - Country:US
Mailing Address - Phone:402-563-7075
Mailing Address - Fax:402-563-7025
Practice Address - Street 1:4100 ADAMY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2973
Practice Address - Country:US
Practice Address - Phone:402-563-7075
Practice Address - Fax:402-563-7025
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24221164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse