Individual
MS. SHELLIE DETTWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3855 SW 120TH ST, AUGUSTA, KS 67010-7758
(316) 775-6237
Mailing address
3855 SW 120TH ST, AUGUSTA, KS 67010-7758
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
81079
KS
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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