Provider Demographics
NPI:1649869538
Name:NEWHOUSE, SADIE GAYLE
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:GAYLE
Last Name:NEWHOUSE
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 1:265 WYATT CT
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1355
Mailing Address - Country:US
Mailing Address - Phone:907-350-4160
Mailing Address - Fax:
Practice Address - Street 1:265 WYATT CT
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1355
Practice Address - Country:US
Practice Address - Phone:907-350-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program