Healthcare Provider Details

I. General information

NPI: 1851020283
Provider Name (Legal Business Name): EMILY GRACE NEWELL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 40TH ST NW APT 2
WASHINGTON DC
20007-1728
US

IV. Provider business mailing address

2208 40TH ST NW
WASHINGTON DC
20007-1728
US

V. Phone/Fax

Practice location:
  • Phone: 630-962-4378
  • Fax:
Mailing address:
  • Phone: 630-962-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4040756
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR243438
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1206347
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: