Healthcare Provider Details

I. General information

NPI: 1528457702
Provider Name (Legal Business Name): JOSHUA SCOTT NEWBY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 N HILL ST
BUFORD GA
30518-2689
US

IV. Provider business mailing address

298 N HILL ST
BUFORD GA
30518-2689
US

V. Phone/Fax

Practice location:
  • Phone: 901-550-8691
  • Fax:
Mailing address:
  • Phone: 901-550-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9308590
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN243802
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: