Individual
SUSIE NEWCOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-CNP
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4168
Mailing address
210 LEE AVE, NITRO, WV 25143-2304
(304) 989-3588
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
120430
WV
363LA2100X
Acute Care Nurse Practitioner
120430
WV
363LA2200X
Adult Health Nurse Practitioner
120430
WV
Other
Enumeration date
08/15/2024
Last updated
04/03/2026
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