Healthcare Provider Details

I. General information

NPI: 1295088425
Provider Name (Legal Business Name): GAIL NEWBY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3543 LITTLE RD STE B
TRINITY FL
34655-1811
US

IV. Provider business mailing address

4104 W LINEBAUGH AVE
TAMPA FL
33624-5239
US

V. Phone/Fax

Practice location:
  • Phone: 727-846-9419
  • Fax:
Mailing address:
  • Phone: 727-846-9419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9231264
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: