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Individual

JENNIFER ELLEN HETRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
885 HIGH ST STE 107, WORTHINGTON, OH 43085-4158
(614) 368-7070
(614) 957-8610
Mailing address
6695 THORNE ST, WORTHINGTON, OH 43085-2431
(646) 831-8044
(614) 957-8610

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
260281
NY
207Q00000X
Family Medicine Physician
Primary
35. 089073
OH
207Q00000X
Family Medicine Physician
MD108705
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0184211
OH
Enumeration date
05/08/2007
Last updated
10/10/2022
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