Provider Demographics
NPI:1023459294
Name:NEWELL, KATHY ANNE (RN NP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:ANNE
Last Name:NEWELL
Suffix:
Gender:F
Credentials:RN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 W VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2129
Mailing Address - Country:US
Mailing Address - Phone:760-737-9733
Mailing Address - Fax:
Practice Address - Street 1:1320 W VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-2129
Practice Address - Country:US
Practice Address - Phone:760-737-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21816363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health