Provider Demographics
NPI:1679947816
Name:NEWTON, DWAN DEMICA (FNP)
Entity type:Individual
Prefix:
First Name:DWAN
Middle Name:DEMICA
Last Name:NEWTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 WATER WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-6705
Mailing Address - Country:US
Mailing Address - Phone:919-697-5474
Mailing Address - Fax:
Practice Address - Street 1:7321 WATER WILLOW DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-6705
Practice Address - Country:US
Practice Address - Phone:919-697-5474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily