Provider Demographics
NPI:1619177284
Name:NEWSOME, ANNETTE SUZANNE (CRTT)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:SUZANNE
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:CRTT
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:SUZANNE
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRTT
Mailing Address - Street 1:7645 E 200 N
Mailing Address - Street 2:
Mailing Address - City:PIERCETON
Mailing Address - State:IN
Mailing Address - Zip Code:46562-9103
Mailing Address - Country:US
Mailing Address - Phone:260-215-2330
Mailing Address - Fax:
Practice Address - Street 1:5901 BROKEN SOUND PKWY
Practice Address - Street 2:500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:561-417-7443
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2278E0002X
IN2278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No2278E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEmergency Care