Provider Demographics
NPI:1902664485
Name:NEWMAN, JESSICA ELIZABETH (APRN-CNM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ELIZABETH
Other - Last Name:KOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNM
Mailing Address - Street 1:1508 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2775
Mailing Address - Country:US
Mailing Address - Phone:937-684-2789
Mailing Address - Fax:
Practice Address - Street 1:1508 GLENN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2775
Practice Address - Country:US
Practice Address - Phone:937-684-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-518435163WS0200X
OHAPRN.CNM.0019644367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WS0200XNursing Service ProvidersRegistered NurseSchool