MEDICARE: LOUISE C RITZ NP

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	363LF0000X	Family Nurse Practitioner	0024164018	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033116108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE C RITZ NP

Provider Business Mailing Address
First Line	:	13550 SMALLWOOD LN
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20151-2519
Country	:	US
Telephone Number	:	703-587-5983
Fax Number	:

Provider Business Practice Location Address
First Line	:	12524 SUNRISE VALLEY DR
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3438
Country	:	US
Telephone Number	:	703-689-2180
Fax Number	:	703-481-3853

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/31/2019

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