Individual
SUSAN LONG NEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3275 HIGHWAY 371 N, MANTACHIE, MS 38855-7145
(662) 282-7555
Mailing address
7441 HIGHWAY 9 S, PONTOTOC, MS 38863-9122
(662) 419-8248
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
897425
MS
363LW0102X
Women's Health Nurse Practitioner
Primary
903617
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
04/24/2019
Last updated
07/15/2021
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