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NPI Code Detail

MEDICARE: MRS. CYNTHIA ANN NEWBY APRN-C

MEDICARE: MRS. CYNTHIA ANN NEWBY APRN-C
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
1363LG0600XGerontology Nurse Practitioner308579-4405UT

General Provider Information

NPI Number : 1558484808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA ANN NEWBY APRN-C
Provider Business Mailing Address
First Line : 1032 LEARNED AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84116-3302
Country : US
Telephone Number : 801-641-9261
Fax Number : 801-521-4496
Provider Business Practice Location Address
First Line : 451 E BISHOP FEDERAL LN
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-2357
Country : US
Telephone Number : 801-641-9261
Fax Number : 801-641-9261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 02/28/2015

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