Provider Demographics
NPI:1699394494
Name:UNANAOWO, EME (RN, NP)
Entity type:Individual
Prefix:
First Name:EME
Middle Name:
Last Name:UNANAOWO
Suffix:
Gender:
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2493 WATERS RUN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-2540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:575 PROFESSIONAL DR STE 290
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3347
Practice Address - Country:US
Practice Address - Phone:770-417-8170
Practice Address - Fax:855-530-3640
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-11
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-173927163W00000X, 363LF0000X
GARN333943163WH0500X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily