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General NPI Number Information
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NPI Number | 1518757087
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Entity Type | Individual
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Provider Name | KELLY LYNN NEWMAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 116 E LIBERTY ST
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City | GIRARD
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State | OH
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Zip | 44420-2648
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Country | US
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Telephone | 330-545-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 5458 LOGAN ARMS DR
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City | GIRARD
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State | OH
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Zip | 44420-1636
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Country | US
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Telephone | 330-727-5599
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024103625
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License Number State | OH
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