Individual
JOSHUA A. HETTRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
446 METROPLEX DR, SUITE A-100, NASHVILLE, TN 37211-3139
(615) 781-0013
Mailing address
446 METROPLEX DR, SUITE A-100, NASHVILLE, TN 37211-3139
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
59693
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3376955
MEDICARE GROUP NUMBER
TN
Enumeration date
11/12/2007
Last updated
11/12/2007
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