Healthcare Provider Details

I. General information

NPI: 1851382824
Provider Name (Legal Business Name): ROSS EDWARD NEWMANN M.S., RN, FNP-C,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5863 SW 189TH PL
ALOHA OR
97078-4578
US

IV. Provider business mailing address

5863 SW 189TH PL
ALOHA OR
97078-4578
US

V. Phone/Fax

Practice location:
  • Phone: 808-780-1838
  • Fax:
Mailing address:
  • Phone: 808-780-1838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60425455
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201392935NP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN - 487
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: