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General NPI Number Information
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NPI Number | 1356692156
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Entity Type | Individual
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Provider Name | KYLA GERMAINE BEAUVAIS NEWMAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 4350 JACKSON RD STE 230
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City | ANN ARBOR
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State | MI
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Zip | 48103-1890
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Country | US
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Telephone | 734-887-4396
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Fax | 734-887-4614
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DR # J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105-9484
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Country | US
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Telephone | 734-747-6766
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601013583
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110004925
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License Number State | VA
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