Healthcare Provider Details

I. General information

NPI: 1902282064
Provider Name (Legal Business Name): JESSICA WOJCICKI NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LANDIS DNP, BSN, RN

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

7850 CONTEE RD APT 489
LAUREL MD
20707-9269
US

V. Phone/Fax

Practice location:
  • Phone: 202-230-9843
  • Fax:
Mailing address:
  • Phone: 240-383-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number28164560A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: