Provider Demographics
NPI:1194364000
Name:NEWTON, TASHA DENISE (RN)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:DENISE
Last Name:NEWTON
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 1:997 ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1709
Mailing Address - Country:US
Mailing Address - Phone:254-350-4263
Mailing Address - Fax:
Practice Address - Street 1:997 ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-1709
Practice Address - Country:US
Practice Address - Phone:254-350-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH465406163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8003Medicaid