Healthcare Provider Details

I. General information

NPI: 1578513966
Provider Name (Legal Business Name): NICOLE ANNE NEWMAN RN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E WILLETTA ST
PHOENIX AZ
85006-2727
US

IV. Provider business mailing address

3390 E HORSESHOE DR
CHANDLER AZ
85249-5923
US

V. Phone/Fax

Practice location:
  • Phone: 602-239-5166
  • Fax:
Mailing address:
  • Phone: 480-883-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN101329
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP1525
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: