Ashlyn Wallace, FNP-C
Nurse Practitioner, Family in Fairfax, VA. Individual provider (NPI-1).
NPI number1104640887
StatusActive
Last updated in NPPESNov 11, 2025
Details
- NPI
- 1104640887
- Entity type
- Individual (NPI-1)
- Name
- Ashlyn Wallace
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 11, 2024
- Certification date
- Nov 11, 2025
- Last updated
- Nov 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 0024191724 | VA | Yes |
Practice location
8613 Route 29 Ste 200nFairfax, VA 22031-2171
Phone 571-350-8400 · Fax 703-280-9596
Mailing address
3040 Williams Dr Ste 100Fairfax, VA 22031-4618
Phone 571-350-8400 · Fax 703-280-9596
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