Provider Demographics
NPI:1649330218
Name:BAKER-NEWSHOLME, BEVERLY (NP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:BAKER-NEWSHOLME
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 CROWN CREST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8881
Mailing Address - Country:US
Mailing Address - Phone:303-840-5051
Mailing Address - Fax:303-840-5058
Practice Address - Street 1:9235 CROWN CREST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8881
Practice Address - Country:US
Practice Address - Phone:303-840-5051
Practice Address - Fax:303-840-5058
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0992099363L00000X
COAPN.00992099-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO900049488Medicaid
GA50BBDSRMedicare ID - Type Unspecified