Provider Demographics
NPI:1376073502
Name:NEWTON-FREEMAN, KAWANSI ELISSA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KAWANSI
Middle Name:ELISSA
Last Name:NEWTON-FREEMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PENNS WAY
Mailing Address - Street 2:SUITE 412
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720
Mailing Address - Country:US
Mailing Address - Phone:302-652-2455
Mailing Address - Fax:
Practice Address - Street 1:27 MARROWS RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3701
Practice Address - Country:US
Practice Address - Phone:302-455-0900
Practice Address - Fax:302-738-0176
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0035337163W00000X
DELG-0001049363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse