Individual
MRS. LISA DAWN REYNOLDS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
410 MAPLE AVE WEST, STE 5, VIENNA, VA 22180
(703) 938-2244
(703) 938-3669
Mailing address
10400 EATON PLACE, STE 410, FAIRFAX, VA 22030
(703) 359-5160
(703) 383-9574
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024164882
VA
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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