Healthcare Provider Details

I. General information

NPI: 1932693017
Provider Name (Legal Business Name): FAITH NEWTON APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-2145
US

IV. Provider business mailing address

1325 PENNSYLVANIA AVE STE 890
FORT WORTH TX
76104-2145
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-8800
  • Fax:
Mailing address:
  • Phone: 817-250-4280
  • Fax: 817-250-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberAP139087
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP139087
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: