Provider Demographics
NPI:1831732411
Name:SOBCZYK, AMY REBECCA (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:REBECCA
Last Name:SOBCZYK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:REBECCA
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1850 CAMERON GLEN DR STE 500
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3343
Mailing Address - Country:US
Mailing Address - Phone:703-481-4121
Mailing Address - Fax:703-435-1961
Practice Address - Street 1:1850 CAMERON GLEN DR STE 500
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3343
Practice Address - Country:US
Practice Address - Phone:703-481-4121
Practice Address - Fax:703-435-1961
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001232040163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse