Provider Demographics
NPI:1356683106
Name:NEWTON-BUTLER, MARY ANGELA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANGELA
Last Name:NEWTON-BUTLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANGELA
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:513 LAUCHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352
Mailing Address - Country:US
Mailing Address - Phone:910-506-4510
Mailing Address - Fax:910-506-4527
Practice Address - Street 1:513 LAUCHWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352
Practice Address - Country:US
Practice Address - Phone:910-506-4510
Practice Address - Fax:910-506-4527
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCC282AOtherMEDICARE