Provider Demographics
NPI:1992533582
Name:WETZEL, ABBY MARIE
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:WETZEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15779 N SR 245
Mailing Address - Street 2:
Mailing Address - City:SANTA CLAUS
Mailing Address - State:IN
Mailing Address - Zip Code:47579
Mailing Address - Country:US
Mailing Address - Phone:812-686-3358
Mailing Address - Fax:
Practice Address - Street 1:15779 N SR 245
Practice Address - Street 2:
Practice Address - City:SANTA CLAUS
Practice Address - State:IN
Practice Address - Zip Code:47579
Practice Address - Country:US
Practice Address - Phone:812-686-3358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program