MEDICARE: LIDIYA GETAHUN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R221247	MD

General Provider Information

NPI Number	:	1629471909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIDIYA GETAHUN

Provider Business Mailing Address
First Line	:	16624 CRABBS BRANCH WAY
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20855-2221
Country	:	US
Telephone Number	:	301-814-5007
Fax Number	:

Provider Business Practice Location Address
First Line	:	18101 PRINCE PHILIP DR
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1514
Country	:	US
Telephone Number	:	301-777-8850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2014
Last Update Date	:	01/13/2026

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Directions to “ LIDIYA GETAHUN ” Practice Location

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