Individual
HEATHER LYNN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001340442
VA
163WC0200X
Critical Care Medicine Registered Nurse
0001340442
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0001340442
VA
Other
Enumeration date
01/28/2025
Last updated
11/04/2025
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