Healthcare Provider Details

I. General information

NPI: 1801720511
Provider Name (Legal Business Name): EMILY GORYEB NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13821 VILLAGE MILL DR STE A
MIDLOTHIAN VA
23114-4314
US

IV. Provider business mailing address

PO BOX 549
MIDLOTHIAN VA
23113-0549
US

V. Phone/Fax

Practice location:
  • Phone: 804-794-2821
  • Fax: 804-794-4072
Mailing address:
  • Phone: 804-794-2821
  • Fax: 804-794-4072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024195349
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: