Provider Demographics
NPI:1467148031
Name:LETANG-NEWMAN, EULINE CARON
Entity Type:Individual
Prefix:
First Name:EULINE
Middle Name:CARON
Last Name:LETANG-NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8722 BOXELDER LN
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-9107
Mailing Address - Country:US
Mailing Address - Phone:734-218-2822
Mailing Address - Fax:
Practice Address - Street 1:8722 BOXELDER LN
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-9107
Practice Address - Country:US
Practice Address - Phone:734-218-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704312257163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency