Provider Demographics
NPI:1477154383
Name:NEWMAN, JULIE JUANITA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JUANITA
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:JUANITA
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1923 E KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-4607
Mailing Address - Country:US
Mailing Address - Phone:417-865-5558
Mailing Address - Fax:417-865-8521
Practice Address - Street 1:1923 E KEARNEY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-4607
Practice Address - Country:US
Practice Address - Phone:417-865-5558
Practice Address - Fax:417-865-8521
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11055183500000X
MO2016002115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR205861OtherNAPB