NPI 1033654470

Angie Detwiler, CNM

Practitioner Advanced Practice Midwife Bloomington, IL

Practice location

Address: 6 Westport CT, Bloomington, IL 61704-8233
Phone: (309) 722-4020

Registered specialties

Advanced Practice Midwife Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367A00000X Licence 209.014746 (IL)

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Registry record

NPI: 1033654470
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Dec 2016
Record last updated: 20 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.