Provider Demographics
NPI:1821042425
Name:NEWBURY, NANCY DEANE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:DEANE
Last Name:NEWBURY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 SE LACREEK CT
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-8954
Mailing Address - Country:US
Mailing Address - Phone:772-545-3993
Mailing Address - Fax:
Practice Address - Street 1:4500 W MIDWAY RD
Practice Address - Street 2:NEW HORIZONS OF THE TREASURE COAST INC
Practice Address - City:FT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981
Practice Address - Country:US
Practice Address - Phone:772-221-4088
Practice Address - Fax:772-221-4089
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1161862363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL763243600Medicaid