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NPI Code Detail

MEDICARE: JENNIFER NEWKIRK PHD

MEDICARE: JENNIFER NEWKIRK PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPS00860RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811947286
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NEWKIRK PHD
Provider Business Mailing Address
First Line : 144 WOODBURY ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02906-3546
Country : US
Telephone Number : 401-490-8947
Fax Number : 401-490-2619
Provider Business Practice Location Address
First Line : 31 RAILROAD AVE
Second Line :
City : WARREN
State : RI
Zip : 02885-3206
Country : US
Telephone Number : 401-490-8947
Fax Number : 401-490-2619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 12/23/2013

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