Healthcare Provider Details

I. General information

NPI: 1174013700
Provider Name (Legal Business Name): EARLENE JEAN RETFORD MSN, APRN/CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6170 LAKOTA DR
CINCINNATI OH
45243-2953
US

IV. Provider business mailing address

6170 LAKOTA DR
CINCINNATI OH
45243-2953
US

V. Phone/Fax

Practice location:
  • Phone: 513-271-9285
  • Fax:
Mailing address:
  • Phone: 513-271-9286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number115040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: