Doctor Name: | AIMEE G NEWSOM |
NPI Number: | 1043695570 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 19631 |
Business Practice Address: | 880 W Moultrie St Suite 200 Winnsboro, SC - 291802411 |
Business Phone Number: | 8036356461 |
Business Fax Number: | 8036354200 |
Mailing Address: | Po Box 1218, WINNSBORO |
State: | SC |
Postal Code: | 291805218 |
Phone Number: | 8036356461 |
Fax Number: | 8036354200 |
NPI Enumeration Date: | 07/27/2015 |
NPI Last Update Date: | 07/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 19631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |