Provider Demographics
NPI:1669631701
Name:NEWTON, MICHELE LEA (LPN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEA
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2492 HUNTER HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:NY
Mailing Address - Zip Code:14855-0075
Mailing Address - Country:US
Mailing Address - Phone:607-792-3329
Mailing Address - Fax:
Practice Address - Street 1:2492 HUNTER HILL ROAD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:NY
Practice Address - Zip Code:14855-0075
Practice Address - Country:US
Practice Address - Phone:607-792-3329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2698941164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02905764Medicaid