Healthcare Provider Details

I. General information

NPI: 1114039005
Provider Name (Legal Business Name): REGINA YVETTE NEWMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16750 W GARFIELD ST
GOODYEAR AZ
85338-6287
US

IV. Provider business mailing address

5001 S PERRYVILLE RD
GOODYEAR AZ
85338-9294
US

V. Phone/Fax

Practice location:
  • Phone: 623-772-4710
  • Fax:
Mailing address:
  • Phone: 623-386-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN128947
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: