Karen M Dettelis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

1965581 Issued in NY

Practice address

23 Smith Ave
Delevan, NY 14042-9661

Phone

(716) 353-1087

NPI assigned

Jun 18, 2010

Last updated

Jun 18, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1811218340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SMITH AVE",
            "city": "DELEVAN",
            "state": "NY",
            "postal_code": "140429661",
            "telephone_number": "716-353-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SMITH AVE",
            "city": "DELEVAN",
            "state": "NY",
            "postal_code": "140429661",
            "telephone_number": "716-353-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTELIS",
        "first_name": "KAREN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "1965581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kandice Joy Debeau, R.N.
• Delevan Volunteer Fire Co Inc
• Ralph Anthony Disarno, LPN
• Marybeth Christina Freitas, MS/CCC-SLP
• Paula S Green, LPN
• Andrew John Haynes
• Stacy Kilburn

• Licensed Practical Nurse in Delevan, NY
• Providers in Delevan, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.