Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaclyn Lutzow

Individual provider Adult Health Nurse Practitioner · NPI 1497469217

Jaclyn Lutzow is a Nurse Practitioner in Philadelphia, Pennsylvania. Graduated from Jefferson Medical College of Thomas Jefferson University in 2022, 4 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
PA
In the registry since
2023
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Practice location Address checks out

3509 N Broad St
Philadelphia, PA 19140-4105
Phone: (215) 707-7200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence SP026727 (PA)

Record details

NPI number1497469217
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 6, 2023
Last updated in NPPESJanuary 6, 2023
Certification dateJanuary 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 2022 (4 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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