Provider Demographics
NPI:1174276943
Name:NEWMAN, DONJA NICOLE
Entity Type:Individual
Prefix:MRS
First Name:DONJA
Middle Name:NICOLE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DONJA
Other - Middle Name:NICOLE
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1030 E CANOE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:KY
Mailing Address - Zip Code:40444-6912
Mailing Address - Country:US
Mailing Address - Phone:859-644-7051
Mailing Address - Fax:
Practice Address - Street 1:1030 E CANOE CREEK RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:KY
Practice Address - Zip Code:40444-6912
Practice Address - Country:US
Practice Address - Phone:859-644-7051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator