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Individual
CASEY DETWILER
Active
Individual
CASEY DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28232046A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71014059A
IN
Other
Enumeration date
03/07/2023
Last updated
07/10/2026
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