Healthcare Provider Details

I. General information

NPI: 1700819372
Provider Name (Legal Business Name): MS. PAULA F NEW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. PAULA F HOUSMAN-NEW

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 HENDERSON DR
JACKSONVILLE NC
28546-5251
US

IV. Provider business mailing address

120 MEMORIAL DR
JACKSONVILLE NC
28546-6328
US

V. Phone/Fax

Practice location:
  • Phone: 910-219-8326
  • Fax: 910-939-4269
Mailing address:
  • Phone: 910-219-8326
  • Fax: 910-939-4269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number201473
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201473
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: