Individual
BENJAMIN EDWARD WYLLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8090 WINDING WAY CT, SPRINGFIELD, VA 22153-2433
(703) 845-1500
Mailing address
8090 WINDING WAY CT, SPRINGFIELD, VA 22153-2433
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024165373
VA
Other
Enumeration date
05/18/2011
Last updated
11/27/2023
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