Provider Demographics
NPI:1508958232
Name:NEWLON, LINDA (RPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:NEWLON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 JANIS RD
Mailing Address - Street 2:
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-2940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:811 3RD ST
Practice Address - Street 2:
Practice Address - City:CARLTON
Practice Address - State:MN
Practice Address - Zip Code:55718-9228
Practice Address - Country:US
Practice Address - Phone:763-689-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN47868NEOtherBCBS
MNHP45842OtherHEALTH PARTNERS
MN6402633OtherMEDICA
MN246533Medicare ID - Type UnspecifiedHDR