Individual
RANDI LEE DETTLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3516 PLANK RD STE 5A, FREDERICKSBURG, VA 22407-6861
(667) 668-2566
Mailing address
2331 YORK RD STE 100, TIMONIUM, MD 21093-2246
(667) 668-2566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110012141
VA
363A00000X
Physician Assistant
C0010358
MD
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
07/10/2026
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