Provider Demographics
NPI:1386333805
Name:NEWMAN, BRENDA LEIGH (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEIGH
Last Name:NEWMAN
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 FRESA LN
Mailing Address - Street 2:
Mailing Address - City:LAUGHLIN
Mailing Address - State:NV
Mailing Address - Zip Code:89029-0736
Mailing Address - Country:US
Mailing Address - Phone:661-348-0990
Mailing Address - Fax:
Practice Address - Street 1:1370 RAMAR RD STE B
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7117
Practice Address - Country:US
Practice Address - Phone:661-348-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV866790363LF0000X
AZ290958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty