Individual
MS. LISA M WYWROT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 504-3000
(703) 504-3388
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024186633
VA
363LA2100X
Acute Care Nurse Practitioner
209022635
IL
Other
Enumeration date
07/27/2021
Last updated
09/28/2023
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