Provider Demographics
NPI:1043070295
Name:NEWBURN, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:NEWBURN
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 1:7 CAMINO DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-9303
Mailing Address - Country:US
Mailing Address - Phone:806-335-5339
Mailing Address - Fax:
Practice Address - Street 1:7 CAMINO DEL NORTE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-9303
Practice Address - Country:US
Practice Address - Phone:806-335-5339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-86201163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health