MS. JOHNNA LYNN DETTIS (NPI# 1700871662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700871662 |
Entity Type | Individual |
Full Name | MS. JOHNNA LYNN DETTIS |
Credential | ARNP |
Practice Address |
3487 Broadway Ave. Fort Myers FL 33901-7213 |
Practice Telephone | 2393349555 |
Practice Fax Number | 2393342832 |
Mailing Telephone | 2393349555 |
Mailing Fax Number | 2393342832 |
Enumeration Date | 2005-09-16 |
Last Update Date | 2013-07-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP2201X |
Registered Nurse Specialization: Ambulatory Care |
1244422 | FL | Nursing Service Providers |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
1244422 | FL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
1244422 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3487 BROADWAY AVE. |
City | FORT MYERS |
State | FL |
Zip Code | 33901-7213 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811536972 | Daniel Wolfe | Speech-Language Pathologist | 3375 Evans Avenue, Fort Myers, FL 33901 | 2020-01-06 |
1841764065 | Medicab Transportation, LLC | Ambulance | 3049 Cleveland Avenue, Suite 275, Fort Myers, FL 33901 | 2019-01-22 |
1760963649 | Jamies Home Care Services LLC | Home Health | 1944 Suwanee Ave, Fort Myers, FL 33901 | 2018-08-28 |
1942673900 | Adriana Ramnarine | Dietitian, Registered | 2727 Winkler Ave., Fort Myers, FL 33901 | 2015-11-12 |
1215327093 | Carecommunity Inc. | Foster Care Agency | 4066 Evans Ave Ste 4, Fort Myers, FL 33901 | 2015-01-30 |
1013327832 | Neck Pain Back Pain and Headache Relief Center of Ft. Myers, LLC | Chiropractor | 4144 Cleveland Ave, Suite 2, Ft. Myers, FL 33901 | 2014-05-01 |
1588087076 | Larry Philip Garrett | Family Medicine | 3543 Stuart Ct, Fort Myers, FL 33901 | 2014-02-04 |
1144657479 | Janet M Michael | Registered Nurse | 3763 Evans Ave., Fort Myers, FL 33901 | 2013-10-01 |
1366879785 | Gina Lee Guerrero | Licensed Practical Nurse | 3736 Evans Ave, Fort Myers, FL 33901 | 2013-09-30 |
1396186649 | Ronald Edward Trapp | Dentist | 2470 Edison Ave, Project Dentists Care of Sw Florida, Fort Myers, FL 33901 | 2013-07-16 |
Find all providers in zip 33901 |
Taxonomy Code | 163WP2201X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Ambulatory Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396351276 | Magaly Camejo | Registered Nurse | 1037 W 23rd St, Hialeah, FL 33010-1922 | 2020-09-16 |
1497368112 | Daphne Nelson | Registered Nurse | 8617 Wilburn Cv, Navarre, FL 32566-6670 | 2020-08-24 |
1578198842 | Cylena P Campbell | Registered Nurse | 10829 Nw 55th St, Coral Springs, FL 33076-2767 | 2020-03-07 |
1174153498 | Krystal Rivera | Registered Nurse | 9703 Hammocks Blvd Apt 208, Miami, FL 33196-1557 | 2020-01-26 |
1306486212 | Dayron Barzaga Dieguez | Registered Nurse | 25931 Sw 132nd Ave, Homestead, FL 33032-6963 | 2020-01-08 |
1851763288 | Yenixis Martinez-castillo | Registered Nurse | 6378 Nw 170th Ln, Hialeah, FL 33015-4629 | 2015-10-26 |
1659766830 | Caroline Heyward Simons | Registered Nurse | 8450 Gate Pkwy W Unit 1007, Jacksonville, FL 32216-1077 | 2015-04-03 |
1710329495 | Johnnetta Nicole Wider | Registered Nurse | 5523 Kilcullen Ln, Jacksonville, FL 32244-6258 | 2013-07-23 |
1386922086 | Robert Kenneth Olan | Registered Nurse | 5852 Roble Loma Dr, Pensacola, FL 32526-2217 | 2011-07-28 |
1356517114 | Linda Elizabeth Moody | Registered Nurse | 715 Seddon Cove Way, Tampa, FL 33602-5702 | 2008-05-01 |
Find all providers with the same taxonomy |
City | FORT MYERS |
Zip Code | 33901 |
Please comment or provide details below to improve the information on MS. JOHNNA LYNN DETTIS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.