Provider Demographics
NPI:1912383480
Name:NEWTON, SYDNEY R (APRN)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:R
Last Name:NEWTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9301 DAYFLOWER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7585
Mailing Address - Country:US
Mailing Address - Phone:502-326-8588
Mailing Address - Fax:502-326-8589
Practice Address - Street 1:3 AUDUBON PLAZA DR
Practice Address - Street 2:SUITE 630
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1300
Practice Address - Country:US
Practice Address - Phone:502-326-8588
Practice Address - Fax:502-326-8589
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009888363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK127540Medicare PIN