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Export Provider Record NPI 1093969404
Nicole L HettrichPA
Active
NPI Number1093969404
NPI TypeNPI-1 Individual
SpecialtyPhysician Assistant, Medical
Provider Details
NPI1093969404
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2008-11-12
Last Updated2017-01-17
Mailing Address1025 Silas Deane Hwy
Wethersfield, CT 06109-4229
United States
Phone: (860) 696-2400 | Fax: (860) 696-2410
📍 View Map
Primary Practice Address1025 Silas Deane Hwy
Wethersfield, CT 06109-4229
United States
Phone: (860) 696-2400 | Fax: (860) 696-2410
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes363AM0700X – Physician Assistant, MedicalCT000972
Export Provider Record NPI 1093969404
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About NPI 1093969404

Nicole L Hettrich PA is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1093969404. The primary specialty listed is Physician Assistant, Medical. The provider is located in Wethersfield, CT. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-11-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1093969404?

NPI 1093969404 belongs to Nicole L Hettrich PA, a Physician Assistant, Medical in Wethersfield, CT. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1093969404 active?

The current status of NPI 1093969404 in the NPPES registry is Active. The record was last updated on 2017-01-17.

What specialty is NPI 1093969404?

NPI 1093969404 is classified under the taxonomy Physician Assistant, Medical. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1093969404?

You can verify NPI 1093969404 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1093969404?

The primary practice address on file for NPI 1093969404 is 1025 Silas Deane Hwy, Wethersfield, CT 06109-4229. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1093969404 issued?

NPI 1093969404 was first issued (enumerated) on 2008-11-12. The NPPES record was last updated on 2017-01-17.

Practice Location Map

Nicole L Hettrich is located at 1025 Silas Deane Hwy, Wethersfield, CT. Use the map below to find directions or verify the practice location.

📍 1025 Silas Deane Hwy, Wethersfield, CT 06109-4229  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Nicole L Hettrich. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1093969404. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Physician Assistant, Medical000972CT
Data Verified from CMS NPPES Last synced: 2026-06-24 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162