Provider Demographics
NPI:1801457809
Name:NEWTON, SAMANTHA NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NICOLE
Last Name:NEWTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 PEBBLE PATH CT
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-2306
Mailing Address - Country:US
Mailing Address - Phone:419-344-6997
Mailing Address - Fax:
Practice Address - Street 1:2030 BLUEGRASS CIR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7328
Practice Address - Country:US
Practice Address - Phone:307-635-3501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995180-NP363LF0000X
OHAPRN.CNP.024903363LF0000X
WY46731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily