Provider Demographics
NPI:1891457610
Name:COLLIER, AISLYNN (PMHNP)
Entity Type:Individual
Prefix:
First Name:AISLYNN
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4124 HAMPSTEAD LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5139
Mailing Address - Country:US
Mailing Address - Phone:801-472-6833
Mailing Address - Fax:
Practice Address - Street 1:100 EAST ST SE STE 301
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4800
Practice Address - Country:US
Practice Address - Phone:703-938-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health