Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP3090732 | FL |
NPI | 1083736615 |
---|---|
Provider Name | Mrs. Elizabeth Kathryn Newman |
First Address | Live Oak, FL 32060-7083 |
Second Address | Lake City, FL 32055-8836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 30/03/2021 |