Individual
KARLENE ANN DETTWILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9695 N 1ST STREET, PROSSER, NE 68883
(402) 984-5783
Mailing address
9695 N 1ST STREET, PROSSER, NE 68883
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
75714
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DETTWILLERK6028
—
AK
Enumeration date
11/08/2017
Last updated
06/16/2018
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