Kettenis, Lia R

Kettenis, Lia R is an individual health care provider with primary practice located at 645 S Rogers St , Bloomington IN 47403-2353. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Kettenis, Lia R can be contacted via phone (812) 269-5092.

Contact Information

Primary practice address
645 S Rogers St Bloomington IN 47403-2353
Phone: (812) 269-5092
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01063824A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01063824A Indiana

Profile Details

NPI number 1346459146
LBN Legal business name Kettenis, Lia R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Mar 5th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1346459146 NPPES
Indiana MEDICAID 200871370A

Popular Providers