Irene E Dettmer
Nurse Practitioner Nurse Practitioner - Adult Health
275 Graham Rd Suite 4
Cuyahoga Falls
, Ohio 44223-2203
Irene E Dettmer
Nurse Practitioner Nurse Practitioner - Adult Health
275 Graham Rd Suite 4
Cuyahoga Falls
, Ohio 44223-2203
(330) 654-2646
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Adult Health
Languages spoken
- English
Location
First Address
- Irene E Dettmer
- 1990 Mahoning Rd
- Deerfield, OH
- Zip : 44411-8735
- Phone : (330) 654-2646
Second Address
- Irene E Dettmer
- 275 Graham Rd Suite 4
- Cuyahoga Falls, OH
- Zip : 44223-2203
- Fax : (330) 926-9428
- Phone : (330) 926-9409
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | NP 04647 | OH |
| Y | 363L00000X | Nurse Practitioner | RN 110530 | OH |
| N | 363LA2200X | Nurse Practitioner - Adult Health | NP04647 | OH |
| N | 363LA2200X | Nurse Practitioner - Adult Health | RN 110530 | OH |
National Provider Identifier
| NPI | 1013919554 |
|---|---|
| Provider Name | Irene E Dettmer |
| First Address | Deerfield, OH 44411-8735 |
| Second Address | Cuyahoga Falls, OH 44223-2203 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/08/2005 |
| Last Update Date | 23/11/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000323216 | BC BS (01) | OH |
| 2096253 | (05) | OH |
| 27YY61105006 | MEDICAL MUTUAL (01) | OH |
| S64559 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.