Dettmer, Irene E
Dettmer, Irene E is an individual health care provider with primary practice located at 275 Graham Rd Suite 4, Cuyahoga Falls OH 44223-2203. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Dettmer, Irene E can be contacted via phone (330) 926-9409.Contact Information
Primary practice address
275 Graham Rd Suite 4
Cuyahoga Falls OH 44223-2203
Phone: (330) 926-9409
Fax: (330) 926-9428
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | RN 110530 | Ohio |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | NP 04647 | Ohio |
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | RN 110530 | Ohio |
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | NP04647 | Ohio |
Profile Details
NPI number | 1013919554 |
---|---|
LBN Legal business name | Dettmer, Irene E |
Credentials | CRNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 15th, 2005 |
Last updated | Nov 23rd, 2007 - about 18 years ago |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013919554 | NPPES |
Ohio | Other | 27YY61105006 | MEDICAL MUTUAL |
Ohio | Other | 000000323216 | MEDICAL MUTUAL |
Ohio | MEDICAID | 2096253 | MEDICAL MUTUAL |
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