Individual
DUSTIN WATTENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9390 BUNSEN PKWY, LOUISVILLE, KY 40220-3789
(833) 358-2278
Mailing address
PO BOX 636493, CINCINNATI, OH 45263-6493
(513) 981-5130
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008537
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100291580
—
KY
Enumeration date
02/21/2014
Last updated
08/17/2022
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