Individual
KENITRA NEWSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, RN
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7343
Mailing address
2350 N STEMMONS FWY, DALLAS, TX 75207-2700
(214) 456-7343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
850672
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP124711
TX
Other
Enumeration date
11/21/2013
Last updated
07/21/2022
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