MEDICARE: AMY ANN NEWSTROM CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CP000608	SD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CP000608	SD

General Provider Information

NPI Number	:	1194030007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ANN NEWSTROM CNP

Provider Business Mailing Address
First Line	:	3939 CANYON LAKE DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0827
Country	:	US
Telephone Number	:	605-716-3555
Fax Number	:	605-413-1143

Provider Business Practice Location Address
First Line	:	3939 CANYON LAKE DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0827
Country	:	US
Telephone Number	:	605-716-3555
Fax Number	:	605-413-1143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	03/12/2026

Similar Medicare Providers

1982251252 — RAPID CITY MENTAL HEALTH PROF. LLC
Practice Location Address:

3939 CANYON LAKE DR STE A
RAPID CITY, SD
57702-0827

Practice Phone: 605-716-3555
Practice Fax: 605-413-1143

1568234813 — RAPID CITY HEALTH PROFESSIONALS LLC
Practice Location Address:

3939 CANYON LAKE DR STE B
RAPID CITY, SD
57702-0827

Practice Phone: 605-716-3555
Practice Fax:

1760156053 — KAMERON MILLS
Practice Location Address:

186 LYNWINN ROAD
COAL CITY, WV
25823-0827

Practice Phone: 304-731-7369
Practice Fax:

1144108804 — MRS. LIDIA ATILANO LCSW
Practice Location Address:

PO BOX 827
HAMILTON CITY, CA
95951-0827

Practice Phone: 530-720-1633
Practice Fax:

1235103060 — DR. MARC E BODDICKER MD
Practice Location Address:

5410 SHERIDAN LAKE RD
RAPID CITY, SD
57702-9208

Practice Phone: 605-390-0900
Practice Fax:

1225090459 — HOLEC AND YOUNG EYE CARE, LLP
Practice Location Address:

2020 JACKSON BLVD STE 1
RAPID CITY, SD
57702-3483

Practice Phone: 605-342-0777
Practice Fax: 605-342-7282

Directions to “ AMY ANN NEWSTROM CNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.