Provider Demographics
NPI:1558803841
Name:NEWMAN, KATHERINE PEEK (MSN, A-GNP, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:PEEK
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MSN, A-GNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 THONOTOSASSA RD STE A
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4202
Mailing Address - Country:US
Mailing Address - Phone:813-567-5679
Mailing Address - Fax:
Practice Address - Street 1:1703 THONOTOSASSA RD STE A
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4202
Practice Address - Country:US
Practice Address - Phone:813-567-5679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9426693363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology