MEDICARE: MRS. EMMA LEDBETTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN248471	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN248471	OTHER	GA	AMERICAN ASSOCIATION OF NURSE PRACTITIONERS

General Provider Information

NPI Number	:	1598246878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMMA LEDBETTER

Provider Business Mailing Address
First Line	:	930 BAKER BRITT RD
Second Line	:
City	:	THOMASTON
State	:	GA
Zip	:	30286-2760
Country	:	US
Telephone Number	:	706-601-1832
Fax Number	:

Provider Business Practice Location Address
First Line	:	3247 NEWNAN RD
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-7114
Country	:	US
Telephone Number	:	770-467-9930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	10/14/2025

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