Active NPI
Preethamole Retnamma
- Family Nurse Practitioner
- Wahpeton, ND
National Provider Identifier
1609773852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 204837
- Practice address
- 1358 12TH St N Apt 111
Wahpeton, ND 58075-5031 - Phone
- (519) 870-8642
- NPI assigned
- Oct 21, 2026
- Last updated
- Oct 21, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 204837 | ND | Primary |
Addresses
Primary practice location
1358 12TH St N Apt 111
Wahpeton, ND 58075-5031
Mailing address
1358 12TH St N Apt 111
Wahpeton, ND 58075-5031
Phone (701) 899-3994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1792540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792540800000",
"number": "1609773852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1358 12TH ST N APT 111",
"city": "WAHPETON",
"state": "ND",
"postal_code": "580755031",
"telephone_number": "701-899-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1358 12TH ST N APT 111",
"city": "WAHPETON",
"state": "ND",
"postal_code": "580755031",
"telephone_number": "519-870-8642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETNAMMA",
"first_name": "PREETHAMOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-10-21",
"last_updated": "2026-10-21",
"certification_date": "2026-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ND",
"license": "204837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wahpeton, ND
- Red River Human Services Foundation
- Red River Human Services Foundation
- Red River Human Services Foundation
- Red River Human Services Foundation
- Red River Human Services Foundation
- Richland County (Richland County Health Department)
- Richland County (Richland County Family Planning)
- Richland County (Richland County Home Health)
- Richland County Social Services
- Richland County Social Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.