Provider Demographics
NPI:1700819372
Name:NEW, PAULA F
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:F
Last Name:NEW
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:F
Other - Last Name:HOUSMAN-NEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:120 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6328
Mailing Address - Country:US
Mailing Address - Phone:910-219-8326
Mailing Address - Fax:910-939-4269
Practice Address - Street 1:3221 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5251
Practice Address - Country:US
Practice Address - Phone:910-219-8326
Practice Address - Fax:910-939-4269
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201473363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562014989OtherTRICARE
NC1700819372Medicaid
NC562014989OtherTRICARE
NC3406870OtherAMBULANCE MEDICAID
NC00007OtherBC
NC3400042Medicaid