Provider Demographics
NPI:1962492116
Name:NEWSOME, STEVEN D (CRNA)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:D
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-0015
Mailing Address - Country:US
Mailing Address - Phone:620-281-3700
Mailing Address - Fax:620-221-9560
Practice Address - Street 1:1300 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2407
Practice Address - Country:US
Practice Address - Phone:620-221-2300
Practice Address - Fax:620-221-9560
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54405367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100249330DMedicaid
KS144726Medicare ID - Type Unspecified