Individual
ELIZABETH J. DETTWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
45-602 KAMEHAMEHA HWY, KANEOHE, HI 96744-2017
(808) 432-3800
Mailing address
45-602 KAMEHAMEHA HWY, KANEOHE, HI 96744-2017
(808) 432-3800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-135
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
530859-01
—
HI
Enumeration date
10/19/2006
Last updated
10/09/2007
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