Individual
WHITNEY J DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-101466
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119829
—
AL
01
—
1437474707
TRICARE
AL
01
—
511-04655
BC BS OF AL
AL
Enumeration date
03/30/2010
Last updated
11/01/2016
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