Provider Demographics
NPI:1700110475
Name:GREENE, EMILY MORGAN (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MORGAN
Last Name:GREENE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT SIDNEY
Mailing Address - State:VA
Mailing Address - Zip Code:24467-2521
Mailing Address - Country:US
Mailing Address - Phone:540-294-1337
Mailing Address - Fax:
Practice Address - Street 1:70 MEDICAL CENTER CIR
Practice Address - Street 2:SUITE 208
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-932-5926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003119363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical