Provider Information for 1184162638
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NICHELL NEWTON
Sex: Female
NPI: 1184162638
Last Updated: 2022-03-11
Certification Date: 2022-02-23
Certification Date: 2022-02-23
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1184162638 | ||||||||||||
| Enumeration Date | 2017-02-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 15105D JOHN J DELANEY DR # 247 CHARLOTTE, NC 28277-2741 United States Phone: 980-477-0334 | Fax: | ||||||||||||
| Primary Practice Address | 1675 CALLAHAN RD FORT MILL, SC 29715-7608 United States Phone: 980-477-0334 | Fax: | ||||||||||||
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