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General NPI Number Information
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NPI Number | 1801700661
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Entity Type | Individual
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Provider Name | MIA AYANNA NEWKIRK RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 600 EAST BLVD
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City | ELKHART
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State | IN
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Zip | 46514-2499
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Country | US
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Telephone | 574-294-2621
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 BEACON CT
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City | MISHAWAKA
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State | IN
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Zip | 46544-6239
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Country | US
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Telephone | 574-347-5067
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 28274281A
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License Number State | IN
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