Individual provider · Type 1 NPI
Jodi A. Dettman, CNP
Adult Health Nurse Practitioner · Edgewood, NM
NPI number
1720269178
Active
Practice location
104 Quail Trl Unit B
Edgewood, NM 87015-7185
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | CNP01152 (NM) |
Adult Health Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1720269178
Jodi A. Dettman, CNP's National Provider Identifier is 1720269178, issued on Nov 14, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Edgewood, NM. The record was last updated on May 4, 2018.