Healthcare Provider Details
I. General information
NPI: 1184672933
Provider Name (Legal Business Name): KATHERINE NEWLAND RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 BURNET AVE ML 5006
CINCINNATI OH
45229-3026
US
IV. Provider business mailing address
3333 BURNET AVE ML 5021
CINCINNATI OH
45229-3026
US
V. Phone/Fax
- Phone: 513-636-9079
- Fax: 513-636-7576
- Phone: 513-636-5013
- Fax: 866-213-7084
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | COA.04765-NP |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: