Provider Demographics
NPI:1881257756
Name:NEWMAN, MARIE THERESA (RN, CWOCN)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:THERESA
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:RN, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 WINNEBAGO ROAD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816
Mailing Address - Country:US
Mailing Address - Phone:301-938-2006
Mailing Address - Fax:
Practice Address - Street 1:6211 WINNEBAGO ROAD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816
Practice Address - Country:US
Practice Address - Phone:301-938-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN41596163WW0000X
MDR077971163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care