Healthcare Provider Details

I. General information

NPI: 1942618699
Provider Name (Legal Business Name): JULIA LYN NEWMAN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 MARKET ST
BOARDMAN OH
44512-4513
US

IV. Provider business mailing address

48361 PANCAKE CLARKSON RD
ROGERS OH
44455-9724
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 330-277-3787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.16275-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: