Provider Demographics
NPI:1285239913
Name:NEWBOULD, FRANCINE ANTONIA (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:ANTONIA
Last Name:NEWBOULD
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9448 AVERY RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-3105
Mailing Address - Country:US
Mailing Address - Phone:216-409-3483
Mailing Address - Fax:
Practice Address - Street 1:9448 AVERY RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-3105
Practice Address - Country:US
Practice Address - Phone:216-409-3483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0370168Medicaid