Provider Demographics
NPI:1437813144
Name:NEWTON, LATOYA KIOTA (FNP)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:KIOTA
Last Name:NEWTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 FASHION SQUARE BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1375
Mailing Address - Country:US
Mailing Address - Phone:989-729-4206
Mailing Address - Fax:989-729-4207
Practice Address - Street 1:4200 FASHION SQUARE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1375
Practice Address - Country:US
Practice Address - Phone:989-729-4206
Practice Address - Fax:989-729-4207
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF10210099363L00000X
MI4704306595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1437813144Medicaid