Individual provider · Type 1 NPI

Ashlyn Wallace, FNP-C

Family Nurse Practitioner · Fairfax, VA

NPI number 1104640887 Active

Practice location

8613 Route 29 Ste 200N
Fairfax, VA 22031-2171

Fax (703) 280-9596

Mailing address

3040 Williams Dr Ste 100
Fairfax, VA 22031-4618

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X0024191724 (VA)

Family Nurse Practitioner: Definition to come...

5 other providers at this address

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About NPI 1104640887

Ashlyn Wallace, FNP-C's National Provider Identifier is 1104640887, issued on Nov 11, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fairfax, VA. The record was last updated on Nov 11, 2025.