Doctor Name: | DAWN MARIE HETZKE |
NPI Number: | 1053567818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 544229 |
Business Practice Address: | 1519 Nye Rd Suite 200 Lyons, NY - 144899133 |
Business Phone Number: | 3159465749 |
Business Fax Number: | |
Mailing Address: | 1519 Nye Rd, Suite 200 LYONS |
State: | NY |
Postal Code: | 144899133 |
Phone Number: | 3159465749 |
Fax Number: | |
NPI Enumeration Date: | 08/13/2008 |
NPI Last Update Date: | 08/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 544229 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |