MEDICARE: KRISTI LYNN NEWTON

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1932885027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI LYNN NEWTON

Provider Business Mailing Address
First Line	:	8478 307TH AVE NE
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-7166
Country	:	US
Telephone Number	:	651-278-2839
Fax Number	:

Provider Business Practice Location Address
First Line	:	6272 MAIN ST
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-6593
Country	:	US
Telephone Number	:	651-674-2700
Fax Number	:

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

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	06/23/2023

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Directions to “ KRISTI LYNN NEWTON ” Practice Location

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