Provider Demographics
NPI:1154583441
Name:DUDLEY, EMILY SARAH (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SARAH
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2855 DENBIGH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GRAFTON
Practice Address - State:VA
Practice Address - Zip Code:23692-6501
Practice Address - Country:US
Practice Address - Phone:757-968-5700
Practice Address - Fax:757-968-5717
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2013-10-22
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Provider Licenses
StateLicense IDTaxonomies
VA0110002824363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant