Provider Demographics
NPI:1184019663
Name:NEWMAN, NICOLE CHRISTINE (PA)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:CHRISTINE
Other - Last Name:SIMMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3915 WATSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1251
Mailing Address - Country:US
Mailing Address - Phone:314-881-0300
Mailing Address - Fax:
Practice Address - Street 1:111 SAINT LUKES CENTER DR BLDG B
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3509
Practice Address - Country:US
Practice Address - Phone:314-205-1926
Practice Address - Fax:314-205-1076
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant