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General NPI Number Information
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NPI Number | 1629767355
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Entity Type | Individual
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Provider Name | EMILY MARIE WINDHAM FNP-C, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 11975 MORRIS RD STE 210
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City | ALPHARETTA
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State | GA
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Zip | 30005-4444
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Country | US
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Telephone | 530-574-0435
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Fax |
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Provider Business Mailing Address
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Address Line | 3503 EMBER ST
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City | MARIETTA
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State | GA
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Zip | 30066-3966
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Country | US
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Telephone | 530-574-0435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN30618
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License Number State | GA
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