Provider Demographics
NPI:1619592516
Name:NEWCOMER, MATTHEW (MSN, APRN, NP-C, CEN)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NEWCOMER
Suffix:
Gender:M
Credentials:MSN, APRN, NP-C, CEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1486 MULFORD RD
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3444
Mailing Address - Country:US
Mailing Address - Phone:567-208-9174
Mailing Address - Fax:
Practice Address - Street 1:2951 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1406
Practice Address - Country:US
Practice Address - Phone:740-454-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.407818163W00000X
OHAPRN.CNP.0026788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse