MEDICARE: LAURA NEWSOME

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	163W00000X	Registered Nurse	86638	SC

General Provider Information

NPI Number	:	1790672582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA NEWSOME

Provider Business Mailing Address
First Line	:	531 S MAIN ST STE 300
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2556
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 S MAIN ST STE 300531S
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2500
Country	:	US
Telephone Number	:	704-302-6257
Fax Number	:

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

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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Directions to “ LAURA NEWSOME ” Practice Location

Language	Start Address	Practice Location

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