Provider Demographics
NPI:1932997749
Name:NEWSOME, JOSHUA JERMAINE (CRNP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JERMAINE
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PERRY HILL RD STE 575
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3630
Mailing Address - Country:US
Mailing Address - Phone:256-470-3037
Mailing Address - Fax:
Practice Address - Street 1:100 PERRY HILL RD STE 575
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3630
Practice Address - Country:US
Practice Address - Phone:256-470-3037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136612363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology