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General NPI Number Information
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NPI Number | 1003495938
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Entity Type | Individual
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Provider Name | CHARISSA MONIQUE NEWKIRK MD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1640 NEIL AVE
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City | COLUMBUS
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State | OH
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Zip | 43201-2333
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Country | US
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Telephone | 614-292-5766
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Fax | 614-688-3440
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Provider Business Mailing Address
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Address Line | 1640 NEIL AVE
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City | COLUMBUS
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State | OH
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Zip | 43201-2333
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Country | US
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Telephone | 614-292-5766
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Fax | 614-688-3440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.153352
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License Number State | OH
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