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

Mrs. Jacqueline Rose Iannicca, MSED, ATC, CSCS

Individual provider Athletic Trainer · NPI 1134237811

Mrs. Jacqueline Rose Iannicca, MSED, ATC, CSCS is an Athletic Trainer in Norfolk, Virginia. Licensed in Virginia. Registered with an NPI since 2006.

Licensed in
VA
In the registry since
2006
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

601 Childrens Ln Sports & Adolescent Medicine
Norfolk, VA 23507-1910
Phone: (757) 668-7850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 0126000528 (VA)

Record details

NPI number1134237811
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSED , ATC , CSCS
Sole proprietorNo
NPI enumeratedAugust 25, 2006
Last updated in NPPESAugust 6, 2014

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