Provider Demographics
NPI:1023230877
Name:NEWSOME, NANCY LYNNE
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYNNE
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:KIRKSEY
Mailing Address - State:KY
Mailing Address - Zip Code:42054-9408
Mailing Address - Country:US
Mailing Address - Phone:127-034-5313
Mailing Address - Fax:127-080-9463
Practice Address - Street 1:1202 PARKER RD
Practice Address - Street 2:
Practice Address - City:KIRKSEY
Practice Address - State:KY
Practice Address - Zip Code:42054-9408
Practice Address - Country:US
Practice Address - Phone:127-034-5313
Practice Address - Fax:127-080-9463
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist