Provider Demographics
NPI:1043591555
Name:NEWBY, DAVID NATHANIEL (APRN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:NATHANIEL
Last Name:NEWBY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N # 8704
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:727-308-3338
Mailing Address - Fax:727-308-3344
Practice Address - Street 1:10557 BLOSSOM LAKE DR
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-7415
Practice Address - Country:US
Practice Address - Phone:727-308-3338
Practice Address - Fax:727-308-3344
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9318418163W00000X
FLAPRN9318418363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health