Provider Demographics
NPI:1689220691
Name:NEWBOLD, ELIDIA BEAS
Entity Type:Individual
Prefix:MRS
First Name:ELIDIA
Middle Name:BEAS
Last Name:NEWBOLD
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 1:9122 E. CALLE MARIA
Mailing Address - Street 2:
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710
Mailing Address - Country:US
Mailing Address - Phone:520-886-3456
Mailing Address - Fax:
Practice Address - Street 1:9122 E. CALLE MARIA
Practice Address - Street 2:
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85710
Practice Address - Country:US
Practice Address - Phone:520-886-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider