Basic Information
| Provider Information | |||||||||
| NPI: | 1205948965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWBERRY | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | FLOW | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 HERITAGE WAY NE | ||||||||
| Address2: | #302 | ||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201764544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037378527 | ||||||||
| FaxNumber: | 7037770170 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 HERITAGE WAY NE | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201764544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037715100 | ||||||||
| FaxNumber: | 7037770170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 0001138447 | VA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.