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General NPI Number Information
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NPI Number | 1639436827
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Entity Type | Individual
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Provider Name | AUSTIN JEANNINE NEWSOME M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 101 ROLESVILLE CENTER RD STE 125
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City | ROLESVILLE
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State | NC
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Zip | 27571-7409
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Country | US
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Telephone | 919-205-4473
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Fax | 919-366-5998
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Provider Business Mailing Address
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Address Line | 101 ROLESVILLE CENTER RD STE 125
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City | ROLESVILLE
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State | NC
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Zip | 27571-7409
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Country | US
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Telephone | 919-205-4473
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 201601845
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License Number State | NC
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