Individual
MRS. AMY BROZICK JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-BC
Contact information
Practice address
1830 TOWN CENTER DRIVE, SUITE 205, RESTON, VA 20190
(703) 435-3636
(703) 435-9145
Mailing address
1100 CLARKE STREET, HERNDON, VA 20170
(412) 215-6709
(703) 331-0959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024171122
VA
Other
Enumeration date
10/17/2014
Last updated
10/16/2024
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