Provider Demographics
NPI:1407886997
Name:NEWMAN, PATRICIA EILEEN (FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:62968 O B RILEY RD
Mailing Address - Street 2:STE 16
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-9442
Mailing Address - Country:US
Mailing Address - Phone:541-318-0178
Mailing Address - Fax:541-318-1050
Practice Address - Street 1:62968 O B RILEY RD
Practice Address - Street 2:STE 16
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-9442
Practice Address - Country:US
Practice Address - Phone:541-318-0178
Practice Address - Fax:541-318-1050
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR81055257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276473Medicaid
ORR102539OtherMEDICARE PTAN
S63223Medicare UPIN