Provider Demographics
NPI:1841969359
Name:NEWSOME, KATIE LAUREN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LAUREN
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1569
Mailing Address - Country:US
Mailing Address - Phone:888-701-4661
Mailing Address - Fax:888-239-2595
Practice Address - Street 1:1069 BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1569
Practice Address - Country:US
Practice Address - Phone:888-701-4661
Practice Address - Fax:888-239-2595
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016644363LF0000X
SC27246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily