Healthcare Provider Details

I. General information

NPI: 1306640321
Provider Name (Legal Business Name): EMILEE ROLAND PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 3RD AVE
ALBANY GA
31701-1985
US

IV. Provider business mailing address

500 W 3RD AVE
ALBANY GA
31701-1985
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-7001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN282826
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberRN282826
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: