Healthcare Provider Details

I. General information

NPI: 1164504650
Provider Name (Legal Business Name): NANCY ANN NEWMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 NORTH PEACHTREE ST.
LINCOLNTON GA
30817
US

IV. Provider business mailing address

417 SUNRISE DR.
LINCOLNTON GA
30817
US

V. Phone/Fax

Practice location:
  • Phone: 706-359-3154
  • Fax: 706-359-1939
Mailing address:
  • Phone: 706-359-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN043485
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: