Provider Demographics
NPI:1598426595
Name:PATEL, HETALBEN N (NP)
Entity Type:Individual
Prefix:
First Name:HETALBEN
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 SOUTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2955
Mailing Address - Country:US
Mailing Address - Phone:844-991-9900
Mailing Address - Fax:212-243-1099
Practice Address - Street 1:1051 SOUTHFIELD DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2955
Practice Address - Country:US
Practice Address - Phone:844-991-9900
Practice Address - Fax:212-243-1099
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28224784A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health