Individual
KELLI DANIELLE WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19490 SANDRIDGE WAY, SUITE 230, LEESBURG, VA 20176-3467
(703) 858-5885
Mailing address
224D CORNWALL ST NW, LEESBURG, VA 20176-2713
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07230133
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306523014
—
VA
05
—
30017669790001
—
VA
Enumeration date
07/04/2023
Last updated
08/21/2025
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