Provider Type Icon

MS. JOHNNA LYNN DETTIS ARNP NPI 1700871662


NPI Information

NPI: 1700871662
Provider Name: MS. JOHNNA LYNN DETTIS, ARNP
Classification: Registered Nurse - 163WP2201X
Entity Type: Individual

Specialization: Ambulatory Care

PECOS Registration: Yes

Address:
3487 BROADWAY AVE.
FORT MYERS, FL
ZIP 33901
Phone: (239) 334-9555
Get Directions

MS. Johnna Lynn Dettis, ARNP is an ambulatory care registered nurse in Fort Myers, FL. MS. Johnna Lynn Dettis, ARNP NPI is 1700871662. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3487 BROADWAY AVE.
FORT MYERS, FL
ZIP 33901-213
Phone: (239) 334-9555
Fax: (239) 334-2832

The NPI 1700871662 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 9/16/2005 and was last updated on 7/24/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily1244422FLORIDANo
2363LW0102XNurse PractitionerWomen's Health1244422FLORIDANo
3163WP2201XRegistered NurseAmbulatory Care1244422FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.