MEDICARE: EMILY GRACE NEWELL CRNA

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	367500000X	Certified Registered Nurse Anesthetist	4040756	KY
2	163WC0200X	Critical Care Medicine Registered Nurse	R243438	MD
3	367500000X	Certified Registered Nurse Anesthetist	1206347	TX

General Provider Information

NPI Number	:	1851020283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY GRACE NEWELL CRNA

Provider Business Mailing Address
First Line	:	2208 40TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-1728
Country	:	US
Telephone Number	:	630-962-4378
Fax Number	:

Provider Business Practice Location Address
First Line	:	2208 40TH ST NW APT 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-1728
Country	:	US
Telephone Number	:	630-962-4378
Fax Number	:

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

Provider Enumeration Date	:	06/09/2022
Last Update Date	:	01/15/2026

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