Dettelbach Lake, Catherine

Dettelbach Lake, Catherine is an individual health care provider with primary practice located at 915 W Monroe St Ste 200 , Jacksonville FL 32204-1177. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Dettelbach Lake, Catherine can be contacted via phone (904) 384-2240.

Contact Information

Primary practice address
915 W Monroe St Ste 200 Jacksonville FL 32204-1177
Phone: (904) 384-2240
Fax: (904) 486-2314
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11006998 Florida
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X APRN11006998 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN11006998 Florida

Profile Details

NPI number 1265039424
LBN Legal business name Dettelbach Lake, Catherine
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2020
Last updated Nov 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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