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Contact Information

LISA A HETTICH, PHARMD, CGP
6651 S COUNTY ROAD 1000 E
CLOVERDALE, IN46120-8528
 Phone: 765-720-2775
 Fax: 765-526-8066
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacotherapy

1835P1200X
Indicates primary specialty

NPI Profile & details for LISA A HETTICH · (Female)

NPI Number 1871598193
Status Active
Credentials PHARMD, CGP
Entity Individual
Enumeration date 06/14/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 26019317A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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