Provider Demographics
NPI:1962493833
Name:NEWELL, THOMAS DAVID (DRNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DAVID
Last Name:NEWELL
Suffix:
Gender:M
Credentials:DRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29423 HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7939
Mailing Address - Country:US
Mailing Address - Phone:940-566-1444
Mailing Address - Fax:940-566-8746
Practice Address - Street 1:1214 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2551
Practice Address - Country:US
Practice Address - Phone:940-566-1444
Practice Address - Fax:940-566-8746
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0100100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily