Provider Demographics
NPI:1497065023
Name:NEWMAN, JENNIFER LYNNE (AP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 N STATE ROAD 7 STE 9
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4378
Mailing Address - Country:US
Mailing Address - Phone:954-255-9355
Mailing Address - Fax:954-255-7990
Practice Address - Street 1:4651 N STATE ROAD 7 STE 9
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4378
Practice Address - Country:US
Practice Address - Phone:954-255-9355
Practice Address - Fax:954-255-7990
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-17
Last Update Date:2010-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2870171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP 2870OtherLICENSED ACUPUNCTURIST