Provider Demographics
NPI:1336464502
Name:NEWCOMER, CHRISTINE ANN (RN, CWOCN, GNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANN
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:RN, CWOCN, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 S HIAWASSEE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5706
Mailing Address - Country:US
Mailing Address - Phone:407-445-9545
Mailing Address - Fax:407-445-9365
Practice Address - Street 1:1507 S HIAWASSEE RD STE 107
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5706
Practice Address - Country:US
Practice Address - Phone:407-445-9545
Practice Address - Fax:407-445-9365
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168741363LG0600X
FLARNP9456691363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology