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NPI Code Detail

MEDICARE: MS. BOBBIE A. NEWSOME NURSE PRACTITIONER

MEDICARE: MS. BOBBIE A. NEWSOME NURSE PRACTITIONER
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
1163W00000XRegistered Nurse675038NY

General Provider Information

NPI Number : 1922791326
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BOBBIE A. NEWSOME NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 107 MONTROSE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14214-1248
Country : US
Telephone Number : 716-474-3517
Fax Number :
Provider Business Practice Location Address
First Line : 107 MONTROSE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14214-1248
Country : US
Telephone Number : 716-474-3517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2023
Last Update Date : 05/31/2023

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Directions to “ MS. BOBBIE A. NEWSOME NURSE PRACTITIONER” Practice Location

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