Healthcare Provider Details

I. General information

NPI: 1538432745
Provider Name (Legal Business Name): JAMILAH K NEWTON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 NW 63RD ST SUITE 106N
OKLAHOMA CITY OK
73116-3632
US

IV. Provider business mailing address

3035 NW 63RD ST SUITE 106N
OKLAHOMA CITY OK
73116-3632
US

V. Phone/Fax

Practice location:
  • Phone: 405-286-9140
  • Fax: 405-286-9136
Mailing address:
  • Phone: 405-286-9140
  • Fax: 405-286-9136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number76316
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: