Healthcare Provider Details

I. General information

NPI: 1265253397
Provider Name (Legal Business Name): CIANA N NEWMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 W GLENDALE AVE
GLENDALE AZ
85303-2611
US

IV. Provider business mailing address

7336 W SOUTHGATE AVE
PHOENIX AZ
85043-2054
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax:
Mailing address:
  • Phone: 480-560-9092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number315745
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: