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CASEY DETWILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7979 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2042
(317) 621-3300
(317) 621-6601
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

Other identifiers
Code
Description
Identifier
Issuer
State
05
300077628
IN
Enumeration date
03/07/2023
Last updated
07/10/2026
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