MRS. AMY BROZICK JACOBSON CPNP-BC NPI 1558765636

NPI Information

  • NPI: 1558765636
  • Provider Name: MRS. AMY BROZICK JACOBSON, CPNP-BC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1830 TOWN CENTER DRIVE
    SUITE 205
    RESTON, VA
    ZIP 20190
  • Phone: (703) 435-3636

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NPI Details

MRS. Amy Brozick Jacobson, CPNP-BC is a pediatrics nurse practitioner in Reston, VA with 12 years of experience. MRS. Amy Brozick Jacobson, CPNP-BC NPI is 1558765636. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1830 TOWN CENTER DRIVE
SUITE 205
RESTON, VA
ZIP 20190
Phone: (703) 435-3636
Fax: (703) 435-9145

The NPI 1558765636 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/17/2014 and was last updated on 10/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics0024171122VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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