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General NPI Number Information
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NPI Number | 1629471909
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Entity Type | Individual
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Provider Name | LIDIYA GETHUN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 18101 PRINCE PHILIP DR
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City | OLNEY
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State | MD
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Zip | 20832-1514
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Country | US
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Telephone | 301-777-8850
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Fax |
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Provider Business Mailing Address
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Address Line | 16624 CRABBS BRANCH WAY
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City | ROCKVILLE
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State | MD
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Zip | 20855-2221
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Country | US
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Telephone | 301-814-5007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R221247
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License Number State | MD
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