Individual
JUSTIN NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
106 MARKET PLACE CIR, GEORGETOWN, KY 40324-7400
(859) 317-6075
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28707
TN
363LF0000X
Family Nurse Practitioner
Primary
3014486
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024180626
LICENSE NUMBER
VA
01
—
2019079870
NATIONAL CERTIFICATION
—
01
—
28707
APRN LICENSE NUMBER
TN
01
—
3-000161
LICENSE NUMBER
AL
01
—
3014486
LICENSE NUMBER
KY
Enumeration date
04/10/2020
Last updated
04/16/2025
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