Healthcare Provider Details

I. General information

NPI: 1497277149
Provider Name (Legal Business Name): HEATHER SIOBHAN NEWHARD CRNP-F
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MITCHELLS CHANCE RD STE 180
EDGEWATER MD
21037-2793
US

IV. Provider business mailing address

6201 GREENLEIGH AVE STE 201
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-8220
  • Fax: 410-367-2118
Mailing address:
  • Phone: 410-451-9091
  • Fax: 410-451-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR194913
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: