Provider Demographics
NPI:1538144886
Name:NEWKIRK, TRIXIE DIANE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TRIXIE
Middle Name:DIANE
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:FNP-C
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 1908
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75403-1908
Mailing Address - Country:US
Mailing Address - Phone:972-454-3025
Mailing Address - Fax:970-450-1408
Practice Address - Street 1:101 N HOUSTON ST
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1950
Practice Address - Country:US
Practice Address - Phone:903-454-3025
Practice Address - Fax:903-450-1408
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00629YMedicare ID - Type Unspecified
TXS69344Medicare UPIN