Provider Demographics
NPI:1134599103
Name:FAULKNER, EMILY RACHEL (NP-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:RACHEL
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RACHEL
Other - Last Name:MCKOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1825 OLD STATE HWY 34
Mailing Address - Street 2:#1300
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265
Mailing Address - Country:US
Mailing Address - Phone:770-502-2121
Mailing Address - Fax:
Practice Address - Street 1:1825 HIGHWAY 34 E
Practice Address - Street 2:SUITE 1300
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-6423
Practice Address - Country:US
Practice Address - Phone:770-512-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA198975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily