Provider Demographics
NPI:1841766581
Name:NEWSOM, CRISTINA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:NEWSOM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:PO BOX 48
Mailing Address - Street 2:
Mailing Address - City:EAST WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04234-0048
Mailing Address - Country:US
Mailing Address - Phone:972-804-6677
Mailing Address - Fax:207-503-5946
Practice Address - Street 1:217 MAIN ST STE 302
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-8193
Practice Address - Country:US
Practice Address - Phone:833-511-8992
Practice Address - Fax:207-503-5946
Is Sole Proprietor?:No
Enumeration Date:2018-10-21
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139410363LP0808X
MECNP201519363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health