Healthcare Provider Details

I. General information

NPI: 1144030305
Provider Name (Legal Business Name): AMY NEWBERRY BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL OKINAWA BUILDING 676
GINOWAN OKINAWA
9012202
JP

IV. Provider business mailing address

PSC 80 BOX 10713
APO AP
96367-0010
US

V. Phone/Fax

Practice location:
  • Phone: 98-971-9355
  • Fax:
Mailing address:
  • Phone: 806-496-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9529098
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: