Provider Demographics
NPI:1588544662
Name:NEWSOME, ALEXANDRIA FAITH
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:FAITH
Last Name:NEWSOME
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:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:HAGERHILL
Mailing Address - State:KY
Mailing Address - Zip Code:41222-0759
Mailing Address - Country:US
Mailing Address - Phone:606-422-9696
Mailing Address - Fax:
Practice Address - Street 1:470 N MAYO TRL
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-1823
Practice Address - Country:US
Practice Address - Phone:606-789-8925
Practice Address - Fax:606-789-5550
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY025397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist