Provider Demographics
NPI:1225208267
Name:NEWLANDS, JOANNA LEE (LPN/CF-M)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:LEE
Last Name:NEWLANDS
Suffix:
Gender:F
Credentials:LPN/CF-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ACADEMY ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3183
Mailing Address - Country:US
Mailing Address - Phone:207-764-7200
Mailing Address - Fax:207-764-7204
Practice Address - Street 1:180 ACADEMY ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3183
Practice Address - Country:US
Practice Address - Phone:207-764-7200
Practice Address - Fax:207-764-7204
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEP011527164W00000X
ABC CERT CFM018311744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME6211750001Medicare NSC