Provider Demographics
NPI:1457827719
Name:NEWLIN, COLLEEN (NP-C, CNM)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:NEWLIN
Suffix:
Gender:F
Credentials:NP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2339
Mailing Address - Country:US
Mailing Address - Phone:810-733-7791
Mailing Address - Fax:
Practice Address - Street 1:1010 N LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-2339
Practice Address - Country:US
Practice Address - Phone:810-733-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704278089363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
0855081OtherBCBS