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General NPI Number Information
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NPI Number | 1912595851
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Entity Type | Individual
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Provider Name | ELIZABETH MAE RETTEW APRN
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Gender | Female
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Dates
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Enumeration Date | 01/06/2021
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 19650 CLUB HOUSE RD # 101
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City | MONTGOMERY VILLAGE
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State | MD
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Zip | 20886-3003
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Country | US
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Telephone | 301-208-1300
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Fax | 301-208-8699
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Provider Business Mailing Address
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Address Line | 1225 4TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-3431
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Country | US
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Telephone | 202-347-8512
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Fax | 202-506-5372
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024185180
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AC008144
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License Number State | MD
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