MRS. Martha Jean Illies, RN

NPI #1881208882 in Lorton, Virginia

Provider Information

NPI Number: 1881208882
Entity Type: Individual
Name: MRS. Martha Jean Illies, RN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: RN
Enumeration Date: Sep 7, 2020
Last Updated: Sep 7, 2020

Practice Location

Address: 8496 SILVERVIEW CT
City: Lorton
State: Virginia
ZIP Code: 22079-4404
Phone: (414) 339-9124

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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