Provider Demographics
NPI:1336161363
Name:NEWMAN, COLLEEN CONNOLLY (CNM)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:CONNOLLY
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 SUMMA AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3726
Mailing Address - Country:US
Mailing Address - Phone:225-761-5200
Mailing Address - Fax:
Practice Address - Street 1:9001 SUMMA AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3726
Practice Address - Country:US
Practice Address - Phone:225-761-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652800367A00000X
MSR866381367A00000X
LA99819367A00000X
LAAP03611367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX36797102Medicaid
TX8YO213OtherBCBS
LA1105708Medicaid
MS05070282Medicaid
TX173155601Medicaid
TX36797102Medicaid
TX173155601Medicaid
TXR29732Medicare UPIN
LA1105708Medicaid