Provider Demographics
NPI:1679091771
Name:NEWSON, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:NEWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 E 63RD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4865
Mailing Address - Country:US
Mailing Address - Phone:816-277-5198
Mailing Address - Fax:
Practice Address - Street 1:8801 E 63RD ST STE 204
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4865
Practice Address - Country:US
Practice Address - Phone:816-277-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MO163WH0200X163WH0200X
MO172A00000X172A00000X
MO374U00000X374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO163WHO200XMedicaid
MO172A00000XMedicaid
MO374U00000XMedicaid
MO133V00000XMedicaid