Provider Demographics
NPI:1972970655
Name:NEWSOME, IMAN SIMONE
Entity Type:Individual
Prefix:
First Name:IMAN
Middle Name:SIMONE
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TAYLOR ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3235
Mailing Address - Country:US
Mailing Address - Phone:202-498-2766
Mailing Address - Fax:
Practice Address - Street 1:2001 TAYLOR ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3235
Practice Address - Country:US
Practice Address - Phone:202-498-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula