Individual
MRS. MARILYN J WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, CRNP,CRNFA,CNOR
Contact information
Practice address
19415 DEERFIELD AVE, SUITE 112, LANSDOWNE, VA 20176-8452
(703) 724-1195
(703) 724-4495
Mailing address
14636 CHAPEL LN, LEESBURG, VA 20176-5276
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024165343
VA
363LF0000X
Family Nurse Practitioner
AC000186
MD
Other
Enumeration date
10/10/2005
Last updated
04/11/2009
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