Provider Demographics
NPI:1467886705
Name:NEWSOME, DELFINA (APRN)
Entity Type:Individual
Prefix:
First Name:DELFINA
Middle Name:
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2226
Mailing Address - Fax:606-237-7530
Practice Address - Street 1:285 SOUTHSIDE MALL RD
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-3905
Practice Address - Country:US
Practice Address - Phone:606-430-2226
Practice Address - Fax:606-237-7530
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100254490Medicaid
KY7100254490Medicaid