Provider Demographics
NPI:1215981659
Name:NEWMAN, DONNA L (RPT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12529 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3135
Mailing Address - Country:US
Mailing Address - Phone:913-696-1036
Mailing Address - Fax:
Practice Address - Street 1:10460 MASTIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5701
Practice Address - Country:US
Practice Address - Phone:913-492-7870
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSL562318Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER