Provider Demographics
NPI:1235704933
Name:NEWMAN, JENNIFER LOU
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOU
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LOU
Other - Last Name:MONTOGMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 CAMBRIA HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26347-3001
Mailing Address - Country:US
Mailing Address - Phone:304-672-0094
Mailing Address - Fax:
Practice Address - Street 1:36 CAMBRIA HOLLOW RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26347-3001
Practice Address - Country:US
Practice Address - Phone:304-672-0094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant