Individual
BENJAMIN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
593 ABERDEEN RD, HAMPTON, VA 23661-1332
(757) 825-1100
Mailing address
2617 S PILOT LN, NAGS HEAD, NC 27959-9077
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024174893
VA
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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