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Individual

MRS. EMILY WALLACE BRANTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4374 NEW TOWN AVE STE 200, WILLIAMSBURG, VA 23188-2865
(757) 984-6110
Mailing address
4374 NEW TOWN AVE STE 200, WILLIAMSBURG, VA 23188-2865
(757) 984-6110

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001270316
VA
363LF0000X
Family Nurse Practitioner
Primary
0024188752
VA

Other

Enumeration date
12/01/2021
Last updated
12/21/2023
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