Jaclyn Lutzow (NPI# 1497469217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1497469217 |
| Entity Type | Individual |
| Full Name | Jaclyn Lutzow |
| Gender | Female |
| Practice Address |
3509 N Broad St Philadelphia PA 19140-4105 |
| Practice Telephone | 2157077200 |
| Mailing Address |
1836 Edmund Rd Abington PA 19001-2012 |
| Mailing Telephone | 2154214339 |
| Sole Proprietor | Yes, this individual is a Sole Proprietor |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 363LA2200X | Nurse Practitioner · Adult Health | Physician Assistants & Advanced Practice Nursing Providers | SP026727 | PA |
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578275087 | Seth Carter Lamming | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2022-12-15 | |
| 1548987977 | Alexandra Thurston | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2022-10-26 | |
| 1609599463 | Aisha R Washington | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2022-09-26 | |
| 1740927680 | Kelly Honore | 925 Chestnut St Fl 4, Philadelphia, PA 19107-4207 | 2022-05-12 | |
| 1952047938 | Rathpagna Norin | 3400 Civic Center Blvd Fl 3, Philadelphia, PA 19104-5127 | 2022-05-11 | |
| 1952047938 | Rathpagna Norin | 833 Chestnut St Ste 703, Philadelphia, PA 19107-4409 | 2022-05-11 | |
| 1578208286 | Amelia Heiss Karlin | 2131 South St Apt 304, Philadelphia, PA 19146-1226 | 2022-04-28 | |
| 1578208286 | Amelia Heiss Karlin | 2131 South St Apt 304, Philadelphia, PA 19146-1226 | 2022-04-28 | |
| 1609519859 | Caryn Michelle Vadseth | 3401 N Broad St Fl Center4, Philadelphia, PA 19140-5189 | 2022-04-15 | |
| 1548913973 | Kelly Morante | 5600 Chestnut St, Philadelphia, PA 19139-3232 | 2022-01-26 | |
| Find all providers in PHILADELPHIA | ||||
| Street Address |
3509 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538890819 | Aidan Pearigen | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2022-06-18 | |
| 1013647577 | Christopher William Ahmed | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2022-06-15 | |
| 1740929868 | Kevin Carmo Bom | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2022-05-27 | |
| 1164188751 | Courtney Alyse Paulus | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2021-11-09 | |
| 1326618935 | Alexander Jonathan Kurtzman | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2021-06-26 | |
| 1245800853 | Katherine Liang | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2021-06-26 | |
| 1932773942 | Marissa Pietrolungo | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2021-05-14 | |
| 1760945778 | Samuel Joseph | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2019-04-08 | |
| 1750841151 | Chloe Beiler | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2019-03-21 | |
| 1770068041 | Chirantan Vinodbhai Mangukia | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 | |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285347930 | Patrick D Green | 1314 W Hunting Park Ave, Philadelphia, PA 19140-2015 | 2022-12-27 | |
| 1417669276 | Natalie Paige Rodriguez | 3322 N Broad St, Philadelphia, PA 19140-5185 | 2022-12-22 | |
| 1871205013 | Susan Brophy | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2022-12-20 | |
| 1033821616 | Nurturing for Living LLC | 1700 W Bristol St, Philadelphia, PA 19140-1808 | 2022-12-15 | |
| 1134830334 | Jennahrational Home Care LLC | 3722 N Sydenham St, Philadelphia, PA 19140-3626 | 2022-12-08 | |
| 1831809789 | Kaveena Julisa Little | 4417 N 6th St, Philadelphia, PA 19140-2319 | 2022-12-01 | |
| 1710697677 | Aigner J Allen | 4509 N 16th St, Philadelphia, PA 19140-1110 | 2022-12-01 | |
| 1699485466 | My Angelic Care LLC | 4248 N Sydenham St, Philadelphia, PA 19140-1925 | 2022-12-01 | |
| 1669181491 | Tieneasha Hines | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2022-11-21 | |
| 1003525429 | Sherry Brooks | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2022-11-15 | |
| Find all providers in zip 19140 | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.