Provider Demographics
NPI:1972257335
Name:NEWTON, DENAH (NP)
Entity Type:Individual
Prefix:
First Name:DENAH
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3957 TROTTERS RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-4894
Mailing Address - Country:US
Mailing Address - Phone:229-563-1499
Mailing Address - Fax:
Practice Address - Street 1:3957 TROTTERS RIDGE CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-4894
Practice Address - Country:US
Practice Address - Phone:229-563-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty