Individual
ASHLEIGH MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
9306 FOREST POINT CIR, MANASSAS, VA 20110-4700
(703) 330-3322
(703) 330-3322
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(551) 295-8223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024182364
VA
Other
Enumeration date
08/14/2021
Last updated
09/11/2025
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