Individual
ELISE HETTENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
789 HOWARD AVE, NEW HAVEN, CT 06519-1304
(888) 461-0106
Mailing address
789 HOWARD AVE, NEW HAVEN, CT 06519-1304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9191
CT
Other
Enumeration date
09/17/2020
Last updated
04/12/2021
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