Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jodi A. Dettman, CNP

Individual provider Adult Health Nurse Practitioner · NPI 1720269178

Jodi A. Dettman, CNP is a Nurse Practitioner in Edgewood, New Mexico. Qualified in 2006, 20 years ago. Accepts Medicare assignment and offers telehealth. Licensed in New Mexico.

Years since qualifying
20
Licensed in
NM
In the registry since
2007
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

104 Quail Trl Unit B
Edgewood, NM 87015-7185
Phone: (505) 208-0204
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence CNP01152 (NM)

Record details

NPI number1720269178
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedNovember 14, 2007
Last updated in NPPESMay 4, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services