Healthcare Provider Details

I. General information

NPI: 1073674396
Provider Name (Legal Business Name): DANIEL L HEDINGER II FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 W 2ND ST
JASPER IN
47546-3240
US

IV. Provider business mailing address

695 W 2ND ST
JASPER IN
47546-3240
US

V. Phone/Fax

Practice location:
  • Phone: 812-996-5750
  • Fax:
Mailing address:
  • Phone: 812-996-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002278A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: