Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LIA R KETTENIS, M.D.
ActiveLIA R KETTENIS, M.D. is a Psychiatric Neurology healthcare provider located in BLOOMINGTON, Indiana. NPI 1346459146 is currently active in the NPPES registry. Verify at CMS.
Psychiatric Neurology · BLOOMINGTON, IN
Registration Details
- NPI Number
- 1346459146
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 21, 2007 (19.241652577956 yrs)
- Last Updated
- Mar 5, 2024
- Licenses
-
01063824A (IN)01063824A (IN)
Practice Information
- Address
-
645 S ROGERS STBLOOMINGTON, IN, 474032353Browse IN providers · Browse ZIP 47403
- Phone
- 8122695092
- Primary Specialty
-
Psychiatric Neurology
2084P0804X
- Additional Specialty
- Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.