EMMIE NORVILLE PARK (NPI# 1912419151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912419151 |
| Entity Type | Individual |
| Full Name | EMMIE NORVILLE PARK |
| Credential | NNP |
| Practice Address |
1120 15th St # 6033 Augusta GA 30912-0004 |
| Mailing Address |
1499 Walton Way Ste 1400 Augusta GA 30901-2603 |
| Practice Telephone | 7067212331 |
| Practice Fax Number | 7067217531 |
| Mailing Telephone | 7064465941 |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2017-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
RN227108 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1120 15TH ST # 6033 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659641058 | Christy Marie Gardner | Nurse Practitioner | 1120 15th St # 6033, Augusta, GA 30912-0004 | 2012-01-03 |
| 1295238723 | Thuy Thu-thi Nguyen | Nurse Practitioner | 1120 15th St # 6033, Augusta, GA 30912-1067 | 2018-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811252919 | Vicky T Kramer | Nurse Practitioner | 15707 Sw Us Hwy 77, Augusta, KS 67010 | 2012-07-05 |
| 1902273261 | Mary Ellen Thompson | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2015-08-21 |
| 1306261441 | April Reid Grant | Nurse Practitioner | 1120 15th St, Suite Number Bi6033, Augusta, GA 30912-0004 | 2014-02-26 |
| 1992027205 | Kristi Thomas Norman | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-3715 | 2010-02-28 |
| 1114137619 | Ashley Hardy Bartley | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2007-05-23 |
| 1285786574 | Rhonda L. Holton | Nurse Practitioner | 1350 Walton Way, 3rd Floor, Augusta, GA 30901-2612 | 2007-01-17 |
| 1124062112 | 84pediatrix Medical Group University Hospital Augusta Ga. | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2629 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265944896 | Jennifer Michelle Kerhin | Nurse Practitioner | 777 Hemlock St Fl 3, Macon, GA 31201-2102 | 2017-11-05 |
| 1871034587 | Stephanie Joseph | Nurse Practitioner | 4316 Sublime Trl, Atlanta, GA 30349-8882 | 2017-03-14 |
| 1659810935 | Stephanie Gale Devers | Nurse Practitioner | 52 Johnny Wortham Rd, Newnan, GA 30263-4823 | 2017-02-19 |
| 1851757520 | Dawn Michelle Tripp | Nurse Practitioner | 10141 Flat Shoals Rd Sw, Covington, GA 30014-3707 | 2016-01-11 |
| 1295080414 | Christa Noel Brown | Nurse Practitioner | 142 Bryce Ryan Cir, Kingsland, GA 31548-7812 | 2012-07-14 |
| 1336398726 | Robin Domm Burch | Nurse Practitioner | 1790 Mulkey Rd Ste 10, Newborn Clinics of America LLC At Wellstar Cobb Clinic, Austell, GA 30106-1122 | 2008-09-10 |
| 1073730032 | Diane Arlene Doherty-chandler | Nurse Practitioner | 1191 Arbor Ln, Madison, GA 30650-3791 | 2007-04-19 |
| 1396886370 | Barbara Elaine Smith | Nurse Practitioner | 5335 Spot Creek Dr, Cumming, GA 30040-9554 | 2007-02-10 |
| 1245315118 | Sara Gelson Martin | Nurse Practitioner | 1762 Clifton Rd Ne Ste 103, Emory University, Atlanta, GA 30322-4001 | 2006-10-26 |
| 1861450058 | Paula Lynn Young | Nurse Practitioner | 2701 North Decatur Rd, Dekalb Medical Center, Decatur, GA 30033 | 2006-05-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.