Individual
MRS. CAROL ARLENE DETTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP
Contact information
Practice address
300 S COLORADO ST STE A, LOCKHART, TX 78644-2707
(512) 376-9690
(512) 398-3755
Mailing address
10802 MARBLE RD, AUSTIN, TX 78750-1516
(512) 773-9652
(512) 398-3755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
235807
TX
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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