Provider Demographics
NPI:1356864938
Name:THE HEALTHY HEDGEHOG WELLNESS COACH, LLC
Entity Type:Organization
Organization Name:THE HEALTHY HEDGEHOG WELLNESS COACH, LLC
Other - Org Name:HEALTHY HEDGEHOG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:502-542-3326
Mailing Address - Street 1:3138 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9465
Mailing Address - Country:US
Mailing Address - Phone:859-533-5331
Mailing Address - Fax:
Practice Address - Street 1:137 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1671
Practice Address - Country:US
Practice Address - Phone:502-542-3326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty