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General NPI Number Information
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NPI Number | 1528324712
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Entity Type | Individual
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Provider Name | TRISTA MARIE NEWVILLE D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 08/07/2022
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Provider Practice Location Address
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Address Line | 12200 W 106TH ST STE 320
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City | OVERLAND PARK
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State | KS
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Zip | 66215-2305
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Country | US
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Telephone | 913-348-4202
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Fax |
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Provider Business Mailing Address
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Address Line | 12200 W 106TH ST STE 320
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City | OVERLAND PARK
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State | KS
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Zip | 66215-2305
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Country | US
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Telephone | 913-348-4202
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Fax | 478-749-9171
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | OP60737835
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 1092
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0102206859
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License Number State | VA
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