Provider Demographics
NPI:1407324593
Name:NEWMAN, EMMALYN BAGGETT (APRN)
Entity Type:Individual
Prefix:MS
First Name:EMMALYN
Middle Name:BAGGETT
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:EMMALYN
Other - Middle Name:GRACE
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3747 ROSWELL RD STE 216
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6227
Mailing Address - Country:US
Mailing Address - Phone:770-973-2272
Mailing Address - Fax:770-973-9245
Practice Address - Street 1:3747 ROSWELL RD STE 216
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-973-2272
Practice Address - Fax:770-973-9245
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9394807363LF0000X
GARN314264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty