Provider Demographics
NPI:1225066749
Name:NEWTON, TINA (CRNA)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3755 ORANGE PL STE 105
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4426
Mailing Address - Country:US
Mailing Address - Phone:216-765-0358
Mailing Address - Fax:216-765-0378
Practice Address - Street 1:3755 ORANGE PL STE 102
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-765-0358
Practice Address - Fax:216-765-0378
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH329670367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered