Individual
CASEY DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1629 MEDICAL ARTS BLVD STE 120, ANDERSON, IN 46011-3454
(765) 298-4220
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28232046A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71014059A
IN
Other
Enumeration date
03/07/2023
Last updated
07/12/2023
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