Provider Demographics
NPI:1285396671
Name:NEWBURG, AMY CHARLENE (PA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CHARLENE
Last Name:NEWBURG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3016 1/2 WOODLAND DR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4537
Mailing Address - Country:US
Mailing Address - Phone:319-929-5673
Mailing Address - Fax:
Practice Address - Street 1:701 10TH ST SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-398-6011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2022-04-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant