MEDICARE: EMMANUELA C CONSEILLANT NP-BC

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	363LP2300X	Primary Care Nurse Practitioner	RN261360	GA
2	363LP2300X	Primary Care Nurse Practitioner	APRN-NP261360	GA

General Provider Information

NPI Number	:	1245988351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUELA C CONSEILLANT NP-BC

Provider Business Mailing Address
First Line	:	2945 STONE HOGAN CONNECTOR RD SW STE 205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2839
Country	:	US
Telephone Number	:	229-234-9695
Fax Number	:	404-343-1846

Provider Business Practice Location Address
First Line	:	2945 STONE HOGAN CONNECTOR RD SW STE 205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2839
Country	:	US
Telephone Number	:	229-234-9695
Fax Number	:	404-343-1846

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

Provider Enumeration Date	:	03/17/2022
Last Update Date	:	02/17/2026

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