Individual
MARISSA HUETTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F166983
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104416834
NATIONAL CERTIFICATION CORPORATION
—
Enumeration date
01/20/2022
Last updated
01/11/2024
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