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NPI Code Detail

MEDICARE: MISS GRACE CY JEAN NEWLAND NP

MEDICARE: MISS GRACE CY JEAN NEWLAND NP
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
1363L00000XNurse Practitioner71015058AIN

General Provider Information

NPI Number : 1780443739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS GRACE CY JEAN NEWLAND NP
Provider Business Mailing Address
First Line : 907 S WINDHAVEN CT
Second Line :
City : NEW PALESTINE
State : IN
Zip : 46163-8882
Country : US
Telephone Number : 317-318-4318
Fax Number :
Provider Business Practice Location Address
First Line : 334 N SENATE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-1708
Country : US
Telephone Number : 224-760-7322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2024
Last Update Date : 03/13/2024

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Directions to “ MISS GRACE CY JEAN NEWLAND NP” Practice Location

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