Healthcare Provider Details

I. General information

NPI: 1932668209
Provider Name (Legal Business Name): JAMIE LYNN NEWMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 03/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 CLEARVISTA DR
INDIANAPOLIS IN
46256-4699
US

IV. Provider business mailing address

6215 ENCLAVE BLVD
GREENWOOD IN
46143-6119
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-5170
  • Fax:
Mailing address:
  • Phone: 317-445-6978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28201196A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: