Individual
MRS. DIANE F HETTEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
140 LINCOLN AVE, WEST MILFORD, NJ 07480-2108
(973) 728-8506
Mailing address
140 LINCOLN AVE, WEST MILFORD, NJ 07480-2108
(973) 728-8506
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
3136781
NY
Other
Enumeration date
06/29/2013
Last updated
06/29/2013
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