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General NPI Number Information
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NPI Number | 1114860970
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Entity Type | Individual
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Provider Name | STEPHANIE NICOLE NEWSOME PMHNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 8402 BLACKJACK RD
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City | MOUNT VERNON
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State | OH
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Zip | 43050-9193
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Country | US
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Telephone | 740-397-0442
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Fax |
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Provider Business Mailing Address
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Address Line | 15793 GIRL SCOUT CAMP RD
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City | UTICA
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State | OH
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Zip | 43080-9735
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Country | US
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Telephone |
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0041904
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License Number State | OH
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