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Individual
MATTHEW ANTHONY HETTENBACH
Active
Individual
MATTHEW ANTHONY HETTENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10089
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10089
WI
Other
Enumeration date
05/29/2020
Last updated
09/24/2026
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