Provider Demographics
NPI:1326367392
Name:NEWMAN, CAROL ANN (FNP)
Entity Type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:ANN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:219 S MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-7464
Mailing Address - Country:US
Mailing Address - Phone:731-422-6630
Mailing Address - Fax:731-935-2866
Practice Address - Street 1:1605 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-7718
Practice Address - Country:US
Practice Address - Phone:731-422-6630
Practice Address - Fax:731-935-2866
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN14985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4275859OtherBCBS
TN1326367392OtherNPI
TNMN2191790OtherDEA
TN4275859OtherBCBS