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Individual

RHONDA JOAN HETTINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1615 BLACKISTON VIEW DR, SUITE E, CLARKSVILLE, IN 47129-2035
(812) 725-1550
(812) 725-1553
Mailing address
1615 BLACKISTON VIEW DR, SUITE E, CLARKSVILLE, IN 47129-2035
(812) 725-1550
(812) 725-1553

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000764A
IN
363LF0000X
Family Nurse Practitioner
3192P
KY
363LF0000X
Family Nurse Practitioner
71000764A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000675091
ANTHEM
IN
05
200265080
IN
05
78004298
KY
Enumeration date
10/10/2005
Last updated
10/20/2015
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