Individual
HENDRA YOSIA SITOMPUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
210 W MAIN ST FL 2, DANVILLE, KY 40422-1812
(859) 236-3726
(859) 236-3019
Mailing address
PO BOX 27766, BELFAST, ME 04915-2029
(888) 488-8289
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3011997
KY
Other
Enumeration date
01/09/2018
Last updated
05/20/2022
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