Healthcare Provider Details

I. General information

NPI: 1225261241
Provider Name (Legal Business Name): EMILEE NEWSOM APPLEGATE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2173 CENTERVILLE PL
TALLAHASSEE FL
32308-8302
US

IV. Provider business mailing address

2810 SWEETBRIAR DR
TALLAHASSEE FL
32312-2751
US

V. Phone/Fax

Practice location:
  • Phone: 850-385-0144
  • Fax:
Mailing address:
  • Phone: 850-580-1583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN9212890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: