Individual
EMMA GRACE POIRIER
Active
Individual
EMMA GRACE POIRIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
10003999A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102860299
ANTHEM PTAN
IN
05
—
300076049
—
IN
Enumeration date
02/13/2023
Last updated
03/05/2025
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