Provider Demographics
NPI:1942289863
Name:NEWMAN, AMY M (RN NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:404 W FOUNTAIN ST
Mailing Address - Street 2:ALBERT LEA MEDICAL CENTER
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-2437
Mailing Address - Country:US
Mailing Address - Phone:507-377-4191
Mailing Address - Fax:
Practice Address - Street 1:404 W FOUNTAIN ST
Practice Address - Street 2:ALBERT LEA MEDICAL CENTER
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-2437
Practice Address - Country:US
Practice Address - Phone:507-377-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1438985363L00000X
MNR-143898-5363L00000X
MN1404363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN109382700Medicaid
500027023OtherRR MEDICARE
142747OtherUCARE (MN)
2406627OtherAMERICA'S PPO (MN)
410849339 56001 C189OtherCHAMPUS
NA2951031967OtherPREFERRED ONE (MN)
0703069OtherMEDICA (MN)
395S6NEOtherBCBS (MN)
HP36305OtherHEALTH PARTNERS (MN)
MN500002136Medicare ID - Type Unspecified
MN500002136Medicare PIN
0703069OtherMEDICA (MN)