Healthcare Provider Details

I. General information

NPI: 1952761108
Provider Name (Legal Business Name): THAIS NEWTON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 LOUGHBORO RD NW STE 320
WASHINGTON DC
20016-2626
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR STE 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 202-660-5555
  • Fax: 202-660-6103
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR219928
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: