Individual
ALISHA KETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5454 HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-2270
(219) 852-2515
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2268
(219) 864-2649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209009914
IL
367500000X
Certified Registered Nurse Anesthetist
28183842A
IN
Other
Enumeration date
11/08/2010
Last updated
10/31/2017
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