Individual
MS. EMILY COUSINEAU SHERBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6920 ROANOKE ROAD, SHAWSVILLE, VA 24162
(540) 268-1400
(540) 268-1300
Mailing address
5975 BURNSIDE LANDING DR, BURKE, VA 22015-2518
(504) 505-0316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-004338
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-01365
NORTH CAROLINA MEDICAL BOARD
—
01
—
0110-004338
COMMONWEALTH OF VIRGINIA
VA
01
—
1081215
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
Enumeration date
06/24/2008
Last updated
09/11/2013
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