Theresa Granitto

Individual provider Active NPI Community Health Registered Nurse · North Potomac, MD

NPI 1639675002 · NPPES record last updated Apr 3, 2018

Key facts

NPI
1639675002
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN1047999 (DC)
Practice address
14630 Keeneland Cir
North Potomac, MD 20878-3771
Phone
(301) 520-7474
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN1047999DCMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN1047999 DC Yes

Addresses

Primary practice location

14630 Keeneland Cir
North Potomac, MD 20878-3771

Mailing address

14630 Keeneland Cir
North Potomac, MD 20878-3771
Phone (301) 520-7474

Other providers in North Potomac, MD

All providers in North Potomac, MD · Community Health Registered Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.