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Individual

JOANN DETWEILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2112 HARRISBURG PIKE, SUITE 200, LANCASTER, PA 17601-2644
(717) 544-3059
(717) 544-3638
Mailing address
2112 HARRISBURG PIKE, SUITE 200, LANCASTER, PA 17601-2644
(717) 544-3059
(717) 544-3638

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
UP-004580-C
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1560009
GATEWAY HEALTH PLAN
PA
01
50067561
CAPITAL BLUE CROSS
PA
01
S49525
HEALTH AMERICA
PA
Enumeration date
04/11/2006
Last updated
04/10/2008
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