Provider Demographics
NPI:1699667865
Name:HETRICK, DENISE (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HETRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 S HARRIS SALEM RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-9339
Mailing Address - Country:US
Mailing Address - Phone:419-307-1171
Mailing Address - Fax:
Practice Address - Street 1:2945 S HARRIS SALEM RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-9339
Practice Address - Country:US
Practice Address - Phone:419-307-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN232849163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse