Individual
JADE ISIS DETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
301 CHESTNUT ST APT 1204, HARRISBURG, PA 17101-2791
(570) 594-2511
Mailing address
301 CHESTNUT ST APT 1204, HARRISBURG, PA 17101-2791
(570) 594-2511
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
PA
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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