Provider Demographics
NPI:1689165862
Name:BIRON, EMMA
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BIRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1312
Mailing Address - Country:US
Mailing Address - Phone:757-681-1219
Mailing Address - Fax:
Practice Address - Street 1:3960 VIRGINIA BEACH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2449
Practice Address - Country:US
Practice Address - Phone:757-668-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant