MEDICARE: EMILY S CUMMINS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN-NP149914	GA

General Provider Information

NPI Number	:	1205078730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY S CUMMINS NP-C

Provider Business Mailing Address
First Line	:	1101 OLD PHILADELPHIA RD # G100
Second Line	:
City	:	JASPER
State	:	GA
Zip	:	30143-4044
Country	:	US
Telephone Number	:	678-971-4167
Fax Number	:	706-253-7060

Provider Business Practice Location Address
First Line	:	1101 OLD PHILADELPHIA RD STE G100
Second Line	:
City	:	JASPER
State	:	GA
Zip	:	30143-4044
Country	:	US
Telephone Number	:	678-971-4167
Fax Number	:	706-253-7060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	10/13/2025

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