Healthcare Provider Details

I. General information

NPI: 1912629015
Provider Name (Legal Business Name): EMILY F FORESMAN AC-PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY FOLTZ

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

PO BOX 9007
CHARLOTTESVILLE VA
22906-9007
US

V. Phone/Fax

Practice location:
  • Phone: 540-758-3424
  • Fax:
Mailing address:
  • Phone: 434-295-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024185232
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number0024185232
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024185232
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: