Provider Demographics
NPI:1285192104
Name:NEWKIRK, MARINDA DAWN (NP-C)
Entity Type:Individual
Prefix:
First Name:MARINDA
Middle Name:DAWN
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1531
Mailing Address - Country:US
Mailing Address - Phone:806-356-0026
Mailing Address - Fax:806-358-3114
Practice Address - Street 1:5211 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4120
Practice Address - Country:US
Practice Address - Phone:806-576-2734
Practice Address - Fax:806-358-3114
Is Sole Proprietor?:No
Enumeration Date:2019-03-10
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140224363LG0600X
TXAPI140224363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner