Provider Demographics
NPI:1114039005
Name:NEWMAN, REGINA YVETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:YVETTE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 S PERRYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9294
Mailing Address - Country:US
Mailing Address - Phone:623-386-4999
Mailing Address - Fax:
Practice Address - Street 1:16750 W GARFIELD ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-6287
Practice Address - Country:US
Practice Address - Phone:623-772-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN128947163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ883092Medicare UPIN