NPI | 1811364300 |
---|---|
Former Name | AMY DETTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9327671) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0037832) |
363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4029272) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 316040) | |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9327671) | |
Enumeration Date | 2015-08-31 |
Last Update Date | 2024-10-29 |