Provider Demographics
NPI:1881906170
Name:RETTIG, AMY E (RN, ACNS-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:RETTIG
Suffix:
Gender:F
Credentials:RN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 OLENTANGY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2339
Mailing Address - Country:US
Mailing Address - Phone:614-261-0796
Mailing Address - Fax:
Practice Address - Street 1:4019 W DUBLIN GRANVILLE RD
Practice Address - Street 2:JAMESCARE IN DULBIN
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1436
Practice Address - Country:US
Practice Address - Phone:614-366-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN227838-COA1364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health