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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013919554 NPPES
Ohio Other 27YY61105006 MEDICAL MUTUAL
Ohio Other 000000323216 MEDICAL MUTUAL
Ohio MEDICAID 2096253 MEDICAL MUTUAL

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