| Doctor Name: | AMANDA B TRUCKSESS |
| NPI Number: | 1366655839 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 0116016644 |
| Business Practice Address: | 1850 Town Center Pkwy Suite 400 Reston, VA - 201903219 |
| Business Phone Number: | 7038105202 |
| Business Fax Number: | |
| Mailing Address: | 11240 Waples Mill Rd 403, FAIRFAX |
| State: | VA |
| Postal Code: | 220306078 |
| Phone Number: | 7033836424 |
| Fax Number: | 7038105369 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 11/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 0116016644 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |