Amy Tanzillo Brucker, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11151036 Issued in VA

Practice address

2313 Jackson Pkwy
Vienna, VA 22180-6914

Phone

(202) 437-2490

NPI assigned

Jun 2, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370131200000",
    "number": "1669819595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 JACKSON PKWY",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806914",
            "telephone_number": "202-437-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 JACKSON PKWY",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806914",
            "telephone_number": "202-437-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "AMY",
        "middle_name": "TANZILLO",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2013-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "11151036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Weldon Brown, DDS
• Shydymond Brown
• Rebecca S. Browne, FNP
• Karen A Browning, PNP
• Anita Marie Bruck, MA, LPC
• Nina Laury Brugel, L.AC.
• Madison Lorene Brumbaugh
• Julia Brzozowski
• BTR Anesthesia, Corp
• Breaywna Lashelle Buchanan

• Lactation Consultant (Non-RN) in Vienna, VA
• Providers in Vienna, VA by specialty
• Lactation Consultant (Non-RN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.