Provider Demographics
NPI:1720847106
Name:TZEUTON, ADELE LEONIE (PMHNP)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:LEONIE
Last Name:TZEUTON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2438 HENSLOWE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6178
Mailing Address - Country:US
Mailing Address - Phone:240-476-8529
Mailing Address - Fax:
Practice Address - Street 1:2438 HENSLOWE DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-6178
Practice Address - Country:US
Practice Address - Phone:240-476-8529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR147871363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health