Provider Demographics
NPI:1689028086
Name:NEWELL, CLAUDETTE MICHELLE
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:MICHELLE
Last Name:NEWELL
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 1:4381 RIVERSIDE DR APT H2
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-1353
Mailing Address - Country:US
Mailing Address - Phone:989-505-0205
Mailing Address - Fax:
Practice Address - Street 1:4381 RIVERSIDE DR APT H2
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-1353
Practice Address - Country:US
Practice Address - Phone:989-505-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker