MEDICARE: EMILY USSERY FNP-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	RN216026	GA

General Provider Information

NPI Number	:	1437621406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY USSERY FNP-C

Provider Business Mailing Address
First Line	:	1105 CHIPWOOD PATH
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-1434
Country	:	US
Telephone Number	:	770-510-9951
Fax Number	:

Provider Business Practice Location Address
First Line	:	1780 PEACHTREE PKWY # 302
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-6834
Country	:	US
Telephone Number	:	770-772-1830
Fax Number	:

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

Provider Enumeration Date	:	01/01/2019
Last Update Date	:	01/01/2019

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Directions to “ EMILY USSERY FNP-C” Practice Location

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