Individual
ANGELA M EMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
759 S MAIN ST, SUITE 300, WOODSTOCK, VA 22664-1127
(540) 459-1540
(540) 459-1486
Mailing address
220 CAMPUS BLVD, STE 200, WINCHESTER, VA 22601-2889
(540) 536-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002693
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017080B36
MEDICARE
VA
05
—
1154591543
—
VA
01
—
54-1948807
TAX ID
—
Enumeration date
03/03/2008
Last updated
02/27/2021
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