Individual
MR. DAVID HETZELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-8141
Mailing address
PO BOX 905, ST JOHNSBURY, VT 05819-0905
(802) 748-8141
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101-0026944
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506267
—
NV
05
—
1008871
—
VT
05
—
3076834
—
NH
Enumeration date
08/16/2005
Last updated
03/31/2015
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