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Individual

JANCI BIENVENU DETWILER

Active
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Individual

JANCI BIENVENU DETWILER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP-PC/AC

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP08962
LA
363LP0222X
Critical Care Pediatric Nurse Practitioner
AP08962
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP08962
STATE LICENSE
LA
Enumeration date
07/22/2016
Last updated
03/04/2021
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