Healthcare Provider Details

I. General information

NPI: 1316540453
Provider Name (Legal Business Name): KATHERINE NEWMAN CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNIE NEWMAN

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-0004
US

IV. Provider business mailing address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-0004
US

V. Phone/Fax

Practice location:
  • Phone: 913-837-6567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number10042015
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: