Healthcare Provider Details

I. General information

NPI: 1093141129
Provider Name (Legal Business Name): LARRY MARTIN NEWMAN DNP, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 COUNCIL ST NE STE B
CEDAR RAPIDS IA
52402-5800
US

IV. Provider business mailing address

5825 COUNCIL ST NE STE B
CEDAR RAPIDS IA
52402-5800
US

V. Phone/Fax

Practice location:
  • Phone: 319-246-2240
  • Fax: 319-246-6098
Mailing address:
  • Phone: 319-246-2240
  • Fax: 319-246-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberH116388
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG161610
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberH116388
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: