Provider Demographics
NPI:1447867338
Name:EICHELBERGER, AMY W (AG-ACNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:W
Last Name:EICHELBERGER
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2158 N QUEBEC ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3965
Mailing Address - Country:US
Mailing Address - Phone:703-304-1004
Mailing Address - Fax:
Practice Address - Street 1:2501 PARKERS LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3209
Practice Address - Country:US
Practice Address - Phone:703-664-7000
Practice Address - Fax:703-664-7666
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN965875363LA2100X
VA0024181068363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care