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Individual

MS. TYRA JO NEWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNP

Contact information

Practice address
11134 N STATE ROAD 77, HAYWARD, WI 54843-5325
(715) 634-5505
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11212
MN
363L00000X
Nurse Practitioner
Primary
14838
WI

Other

Enumeration date
12/11/2023
Last updated
01/25/2024
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