Healthcare Provider Details

I. General information

NPI: 1730927203
Provider Name (Legal Business Name): MADISON M NEWTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON M WILLIAMS RN

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4963 W TUMBLEWEED ST
FAYETTEVILLE AR
72704-7645
US

IV. Provider business mailing address

PO BOX 808
THORNBURG VA
22565-0808
US

V. Phone/Fax

Practice location:
  • Phone: 479-841-9164
  • Fax:
Mailing address:
  • Phone: 479-841-9164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberR105379
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberR105379
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR105379
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR105379
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR105379
License Number StateAR
# 7
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License NumberR105379
License Number StateAR
# 8
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR105379
License Number StateAR
# 9
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License NumberR105379
License Number StateAR
# 10
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberR105379
License Number StateAR
# 11
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR105379
License Number StateAR
# 12
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberR105379
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: