Healthcare Provider Details

I. General information

NPI: 1417126897
Provider Name (Legal Business Name): L'ANITA R NEWBY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 E HUDSON BLVD
GASTONIA NC
28054-1694
US

IV. Provider business mailing address

1075 E HUDSON BLVD
GASTONIA NC
28054-1694
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-216-3854
Mailing address:
  • Phone: 866-389-2727
  • Fax: 401-216-3854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number189759
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number189759
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number189759
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number189759
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number189759
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNA
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: