Provider Demographics
NPI:1093288821
Name:NEWELL, KRISTY (CPM)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9969 WAGNER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-7804
Mailing Address - Country:US
Mailing Address - Phone:541-660-9849
Mailing Address - Fax:
Practice Address - Street 1:9969 WAGNER CREEK RD
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-7804
Practice Address - Country:US
Practice Address - Phone:541-660-9849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife