Individual
ELISABETH ANNE BOETTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
381 ELDEN ST STE 1000, HERNDON, VA 20170-4842
(703) 424-4671
Mailing address
14622 CROATAN DR, CENTREVILLE, VA 20120-2981
(703) 424-4671
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001268093
VA
363LF0000X
Family Nurse Practitioner
Primary
0024196642
VA
Other
Enumeration date
02/18/2026
Last updated
03/23/2026
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