Individual
GUINEVERE ZIMMERMAN LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8081 INNOVATION PARK DR, FAIRFAX, VA 22031-4867
(571) 472-4724
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001271747
VA
363LF0000X
Family Nurse Practitioner
Primary
0024179561
VA
Other
Enumeration date
03/10/2020
Last updated
05/06/2022
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