Provider Demographics
NPI:1598908121
Name:NEWBERRY, TOBIE SUZANNE
Entity Type:Individual
Prefix:MRS
First Name:TOBIE
Middle Name:SUZANNE
Last Name:NEWBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOBIE
Other - Middle Name:SUZANNE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:GROSVENOR HALL 055
Mailing Address - Street 2:OHIO UNIVERSITY
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2979
Mailing Address - Country:US
Mailing Address - Phone:740-593-2432
Mailing Address - Fax:
Practice Address - Street 1:300 E 8TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3379
Practice Address - Country:US
Practice Address - Phone:740-374-4273
Practice Address - Fax:740-376-5098
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV56404363L00000X
OH287491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner