Individual
EMILY TANSKI GUNNELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19490 SANDRIDGE WAY, SUITE 210, LEESBURG, VA 20176-3467
(703) 723-7504
Mailing address
224-D CORNWALL STREET, NW., SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004340
VA
363A00000X
Physician Assistant
PA030814
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750650073
—
VA
05
—
30015769690003
—
VA
Enumeration date
12/14/2011
Last updated
10/18/2023
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