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General NPI Number Information
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NPI Number | 1205602273
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Entity Type | Individual
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Provider Name | EMMALEIGH ANA MONDELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 1870 AMHERST ST STE 3D
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City | WINCHESTER
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State | VA
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Zip | 22601-2873
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Country | US
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Telephone | 540-536-5840
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Fax | 540-536-5841
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Provider Business Mailing Address
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Address Line | 220 CAMPUS BLVD STE 320
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City | WINCHESTER
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State | VA
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Zip | 22601-2889
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Country | US
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Telephone | 540-536-5100
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Fax | 540-536-0235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3022
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110011515
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License Number State | VA
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