Provider Demographics
NPI:1275747081
Name:NEWMAN, COURTNEY SUZANNE (RN APN WHCNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SUZANNE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RN APN WHCNP
Other - Prefix:
Other - First Name:COURNEY
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 TOWN CREEK RD E
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5690
Mailing Address - Country:US
Mailing Address - Phone:865-635-0015
Mailing Address - Fax:865-635-0046
Practice Address - Street 1:6221 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4022
Practice Address - Country:US
Practice Address - Phone:865-635-0015
Practice Address - Fax:865-635-0015
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN125135363LW0102X
TNAPN7957363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01183224Medicare PIN