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NPI Code Detail

MEDICARE: DAWN KRETZ DNP, CPNP-PC, IBCLC

MEDICARE: DAWN KRETZ DNP, CPNP-PC, IBCLC
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
1163W00000XRegistered NurseR167581MD
2363LP0200XPediatric Nurse PractitionerR167581MD

General Provider Information

NPI Number : 1629442256
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN KRETZ DNP, CPNP-PC, IBCLC
Provider Business Mailing Address
First Line : 4105 GREAT OAK RD
Second Line :
City : ROCKVILLE
State : MD
Zip : 20853-1854
Country : US
Telephone Number : 917-822-9031
Fax Number :
Provider Business Practice Location Address
First Line : 4105 GREAT OAK RD
Second Line :
City : ROCKVILLE
State : MD
Zip : 20853-1854
Country : US
Telephone Number : 917-822-9031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2015
Last Update Date : 07/13/2023

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