Provider Demographics
NPI:1427786607
Name:PICARRA, EMERALD GRACE (NP)
Entity type:Individual
Prefix:
First Name:EMERALD
Middle Name:GRACE
Last Name:PICARRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMERALD
Other - Middle Name:GRACE
Other - Last Name:GUILLERGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1980 LONG BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1980 LONG BRANCH CT
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7398
Practice Address - Country:US
Practice Address - Phone:434-604-0983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF0822034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine