Individual
EMILY NICOLE REALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(717) 468-9167
Mailing address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110008430
VA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110008430
VIRGINIA BOARD OF MEDICINE
VA
01
—
1190104
NCCPA
—
Enumeration date
10/23/2021
Last updated
09/05/2022
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