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General NPI Number Information
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NPI Number | 1083434732
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Entity Type | Individual
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Provider Name | JUSTIN NEWMAN APRN, FNP
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Gender | Male
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 362 S BURNETT RD
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City | SPRINGFIELD
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State | OH
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Zip | 45505-2604
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Country | US
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Telephone | 937-525-2470
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Fax | 937-525-2432
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Provider Business Mailing Address
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Address Line | 362 S BURNETT RD
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City | SPRINGFIELD
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State | OH
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Zip | 45505-2604
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Country | US
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Telephone | 937-525-2470
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Fax | 937-525-2432
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0038281
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | RN.364679
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License Number State | OH
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