Drs. Detrick & Detrick INC.
Nurse Practitioner, Family in Maumee, OH. Organization (NPI-2).
NPI number1114144300
StatusActive
Last updated in NPPESApr 22, 2008
Details
- NPI
- 1114144300
- Entity type
- Organization (NPI-2)
- Legal business name
- Drs. Detrick & Detrick INC.
- Organization subpart
- No
- Enumeration date
- Apr 19, 2007
- Last updated
- Apr 22, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 032039822 | OH | Yes |
| 163WR0006X | Registered Nurse, Registered Nurse First Assistant | RN113039 | OH |
Practice location
5757 Monclova RoadSuite 14
Maumee, OH 43537
Phone 419-893-3316
Mailing address
5757 Monclova RoadSuite 14
Maumee, OH 43537
Phone 419-893-3316
Authorized official
Cyndee J Detrick
Office Manager
4198933316
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