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Individual
WANDA CAROL NEWSOME
Active
Individual
WANDA CAROL NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201908923NP-PP
OR
363LF0000X
Family Nurse Practitioner
R870610
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01133325
—
MS
01
—
9876741
AETNA
MS
01
—
P01341901
RAILROAD MEDICARE
MS
Enumeration date
09/22/2011
Last updated
04/29/2026
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