Provider Demographics
NPI:1366883621
Name:NEWSOME-WILLIAMS, JACQUELINE MCDARRY (PHDRN,ANP-BC, FNP)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:MCDARRY
Last Name:NEWSOME-WILLIAMS
Suffix:
Gender:F
Credentials:PHDRN,ANP-BC, FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70861
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20813-0861
Mailing Address - Country:US
Mailing Address - Phone:202-558-0504
Mailing Address - Fax:202-558-0508
Practice Address - Street 1:7700 OLD BRANCH AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1628
Practice Address - Country:US
Practice Address - Phone:202-558-0504
Practice Address - Fax:202-558-0508
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR187582207Q00000X
DCRN1018191207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine