KRISTEN DETTMER PNP
NPI 1235985938
Nurse Practitioner in Fort Wayne, IN

Q: What is Kristen Dettmer's NPI number?

The NPI number for Kristen Dettmer is 1235985938. It was assigned to this individual provider in the NPPES registry on April 24, 2024.

Q: What is Kristen Dettmer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kristen Dettmer was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2024

11115 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845(260) 266-5400(260) 425-5715 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 3, 2024, Jul 15, 2024, Apr 24, 2024 (3 updates tracked since 2024).

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About Kristen Dettmer Pnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTEN DETTMER PNP (NPI 1235985938) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (28210703A) and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1235985938

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKRISTEN DETTMERCredential: PNP

Location Address11115 PARKVIEW PLAZA DRFort Wayne, IN 46845-1701

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701

Phone(260) 266-5400

Fax(260) 425-5715

Sole ProprietorNo

Enumeration DateApril 24, 2024

Last NPPES UpdateSeptember 3, 20243 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2024

✔ NPI 1235985938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 28210703A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License 28210703A (IN)

11115 PARKVIEW PLAZA DR, Fort Wayne, IN 46845

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MELISSA S RICE D.O.

Pediatrics (Neonatal-Perinatal Medicine)