Individual
ELLEN DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2106 W HUNTINGTON AVE, ANAHEIM, CA 92801-1625
(714) 612-6578
Mailing address
2106 W HUNTINGTON AVE, ANAHEIM, CA 92801-1625
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95032024
CA
Other
Enumeration date
05/24/2025
Last updated
05/24/2025
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