Healthcare Provider Details

I. General information

NPI: 1598309775
Provider Name (Legal Business Name): EMILY BOXX NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 STILLMAN PKWY
GLEN ALLEN VA
23060-4197
US

IV. Provider business mailing address

3960 STILLMAN PKWY
GLEN ALLEN VA
23060-4197
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-2320
  • Fax:
Mailing address:
  • Phone: 804-285-2320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024177750
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0024177750
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: