Individual
MS. JEANETTE ETHRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7522 GREER DR, FORT WASHINGTON, MD 20744-3319
(301) 648-5725
Mailing address
7522 GREER DR, FORT WASHINGTON, MD 20744-3319
(301) 648-5725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1006588
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP1006588
DC
Other
Enumeration date
12/30/2021
Last updated
07/25/2023
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