Individual
MARY NEWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AANP
Contact information
Practice address
2100 MILLVALE RD, LOUISVILLE, KY 40205-1604
(502) 451-0990
Mailing address
12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
(502) 568-7366
(502) 568-7114
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007590
KY
363LF0000X
Family Nurse Practitioner
APN3007590
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100263870
—
KY
Enumeration date
10/08/2012
Last updated
05/18/2015
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