MEDICARE: JAMIE LYNN NEWMAN RN

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
1	163WM0705X	Medical-Surgical Registered Nurse	28201196A	IN

General Provider Information

NPI Number	:	1932668209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE LYNN NEWMAN RN

Provider Business Mailing Address
First Line	:	6215 ENCLAVE BLVD
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-6119
Country	:	US
Telephone Number	:	317-445-6978
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 CLEARVISTA DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4699
Country	:	US
Telephone Number	:	317-621-5170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2019
Last Update Date	:	03/17/2019

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