| Doctor Name: | DEBRA NEWBOLDS |
| NPI Number: | 1114384583 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 041259452 |
| Business Practice Address: | 117 Weisbrook Ln Carterville, IL - 629182320 |
| Business Phone Number: | 6187271977 |
| Business Fax Number: | |
| Mailing Address: | 117 Weisbrook Ln, CARTERVILLE |
| State: | IL |
| Postal Code: | 629182320 |
| Phone Number: | 6187271977 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2016 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 041259452 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |