Provider Demographics
NPI:1366077075
Name:NEWMANN-GODFUL, CHRISTIANA
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:
Last Name:NEWMANN-GODFUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13607 67TH AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-6342
Mailing Address - Country:US
Mailing Address - Phone:253-250-8326
Mailing Address - Fax:253-301-1862
Practice Address - Street 1:13607 67TH AVE E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-6342
Practice Address - Country:US
Practice Address - Phone:253-250-8326
Practice Address - Fax:253-301-1862
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60569574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty