Provider Demographics
NPI:1437241999
Name:NEWTON, LAURIE A (NP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:A
Last Name:NEWTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:A
Other - Last Name:EKKEBUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC OTOLARYNGOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-2657
Mailing Address - Fax:414-266-2693
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC OTOLARYNGOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2657
Practice Address - Fax:414-266-2693
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI144764363L00000X
WI3002363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1437241999Medicaid
WI059U 73-601Medicare PIN
WI680860508Medicare PIN