Healthcare Provider Details

I. General information

NPI: 1083617732
Provider Name (Legal Business Name): KATHERINE F NEWCOMB C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MAIN ST
NORWAY ME
04268-5664
US

IV. Provider business mailing address

PO BOX 346
NORWAY ME
04268-0346
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-5933
  • Fax:
Mailing address:
  • Phone: 207-743-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR021824
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: