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General NPI Number Information
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NPI Number | 1720867781
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Entity Type | Individual
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Provider Name | MEGAN RETTEW MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 19450 DEERFIELD AVENUE, SUITE 300
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City | LEESBURG
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State | VA
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Zip | 20176-6821
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Country | US
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Telephone | 703-858-3220
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Fax |
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Provider Business Mailing Address
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Address Line | 224-D CORNWALL STREET, NW, SUITE 403
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City | LEESBURG
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State | VA
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Zip | 20176-2704
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Country | US
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Telephone | 703-737-6010
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024188313
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License Number State | VA
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