Provider Demographics
NPI:1316984438
Name:MORETTI, ANNA MARIE (CRNP)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MARIE
Last Name:MORETTI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13109 RIVIERA TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3582
Mailing Address - Country:US
Mailing Address - Phone:301-625-3269
Mailing Address - Fax:
Practice Address - Street 1:1355 PICCARD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4315
Practice Address - Country:US
Practice Address - Phone:301-926-1675
Practice Address - Fax:301-926-4185
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR095345363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP45198Medicare UPIN
MD0A867P01Medicare ID - Type Unspecified