Individual
SAMANTHA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10521 ROSEHAVEN ST STE LL100, FAIRFAX, VA 22030-2877
(703) 281-5000
(703) 255-0765
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(013) 408-3393
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
0024177383
VA
363LW0102X
Women's Health Nurse Practitioner
RN1021762
DC
Other
Enumeration date
06/06/2019
Last updated
12/05/2023
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