Provider Demographics
NPI:1932204393
Name:NEWELL, MARCIA (FNP)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 N 22ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-5306
Mailing Address - Country:US
Mailing Address - Phone:307-745-3704
Mailing Address - Fax:307-745-7237
Practice Address - Street 1:1252 N 22ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-5306
Practice Address - Country:US
Practice Address - Phone:307-745-3704
Practice Address - Fax:307-745-7237
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY13353.0723363LF0000X
COAPN.0991718-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY13353.0723OtherSTATE BOARD OF NURSING
WY13353.0723OtherSTATE BOARD OF NURSING