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NPI Code Detail

MEDICARE: MANDY M NEWTON ROSENOW PA

MEDICARE: MANDY M NEWTON ROSENOW PA
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
1363A00000XPhysician Assistant0110002047VA
2363A00000XPhysician Assistant5601005731MI
3363A00000XPhysician Assistant0010-00508NC
4363A00000XPhysician AssistantMA052924PA
5363A00000XPhysician Assistant001608IA

General Provider Information

NPI Number : 1871572974
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY M NEWTON ROSENOW PA
Provider Business Mailing Address
First Line : 9943 HICKMAN RD
Second Line : SUITE 105
City : URBANDALE
State : IA
Zip : 50322-5304
Country : US
Telephone Number : 515-248-1447
Fax Number : 515-248-1440
Provider Business Practice Location Address
First Line : 3509 E 29TH ST
Second Line :
City : DES MOINES
State : IA
Zip : 50317-4253
Country : US
Telephone Number : 515-248-1600
Fax Number : 515-248-1610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 02/15/2016

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Directions to “ MANDY M NEWTON ROSENOW PA” Practice Location

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