National Provider Identifier
Michelle L Dettman, RN
Michelle L Dettman, RN is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Registered Nurse in Buffalo, NY and a listed phone number of (716) 566-1870.
Profile Overview
- NPI
- 1598309700
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Registered Nurse
- Enumeration Date
- October 30, 2019
- Last Updated
- February 22, 2022
Practice Location
- 430 Niagara St
- Buffalo, NY 14201-1886
Phone: (716) 566-1870
Specialties
- Psychiatric/Mental Health Registered Nurse (163WP0808X)
Full Record
- NPI
- 1598309700
- Entity Type
- Individual
- Last Name
- Dettman
- First Name
- Michelle
- Middle Name
- L
- Credential
- RN
- Mailing Street Address
- 430 Niagara St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14201-1886
- Mailing Country
- US
- Mailing Phone
- (716) 566-1870
- Mailing Fax
- (716) 551-0891
- Practice Street Address
- 430 Niagara St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14201-1886
- Practice Country
- US
- Practice Phone
- (716) 566-1870
- Practice Fax
- (716) 551-0891
- Enumeration Date
- October 30, 2019
- Last Updated
- February 22, 2022
- Deactivation Date
- February 07, 2022
- Reactivation Date
- February 21, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 22, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Registered Nurse (163WP0808X)
- Other Identifiers
- 750549 (NY)