Individual
MS. LISA A WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP,CNM
Contact information
Practice address
4379 RIDGEWOOD CENTER DR, STE 102, WOODBRIDGE, VA 22192-8323
(703) 680-7950
(703) 680-7953
Mailing address
4379 RIDGEWOOD CENTER DR, STE 102, WOODBRIDGE, VA 22192-8322
(703) 680-7950
(703) 680-7953
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0001096818
VA
367A00000X
Advanced Practice Midwife
Primary
0024096818
VA
Other
Enumeration date
01/02/2007
Last updated
05/01/2012
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