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Individual

LYNN GRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11213 ROUTE 29 STE H, FAIRFAX, VA 22030-5698
(703) 832-8023
(703) 776-9499
Mailing address
11213 ROUTE 29 STE H, FAIRFAX, VA 22030-5698
(703) 832-8023
(703) 776-9499

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024164906
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1588615710
NPI
VA
05
8935823
VA
Enumeration date
05/12/2006
Last updated
09/02/2025
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