Individual
SAMUEL LWANYAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGPCNP
Contact information
Practice address
7501 HERITAGE VILLAGE PLZ, GAINESVILLE, VA 20155-3078
(157) 150-5285
(571) 248-6455
Mailing address
10211 WATERBURY CT, MANASSAS, VA 20110-6143
(157) 505-2853
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024189728
VA
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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