Provider Demographics
NPI:1174013700
Name:RETFORD, EARLENE JEAN (MSN, APRN/CNS)
Entity type:Individual
Prefix:
First Name:EARLENE
Middle Name:JEAN
Last Name:RETFORD
Suffix:
Gender:F
Credentials:MSN, APRN/CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6170 LAKOTA DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2953
Mailing Address - Country:US
Mailing Address - Phone:513-271-9286
Mailing Address - Fax:
Practice Address - Street 1:6170 LAKOTA DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2953
Practice Address - Country:US
Practice Address - Phone:513-271-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH115040163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice