Provider Demographics
NPI:1356309173
Name:GIRARD, EMILY B (PA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:B
Last Name:GIRARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1850 ROSSER AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3237
Practice Address - Country:US
Practice Address - Phone:540-942-1200
Practice Address - Fax:540-942-0151
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001873363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00126080OtherRAILROAD MEDICARE
VA005155H55Medicare PIN
VA010131324Medicare PIN
VAP00126080OtherRAILROAD MEDICARE