Most Relevant Information
Provider Data
| NPI Number: | 1003231432 |
| Provider Name: | DUSTIN WATTENBERGER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3008537 |
Most Important Dates
| Enumeration Date: | 02/21/2014 |
| Last Updated: | 08/17/2022 |
Provider Practice Location
9390 BUNSEN PKWY
LOUISVILLE
KY
402203789
Practice Location Phone/Fax
| Phone: | 8333582278 |
| Fax: |
Provider Mailing Location
PO BOX 636493
CINCINNATI
OH
452636493
Provider Mailing Phone/Fax
| Phone: | 5139815130 |
| Fax: | 5139815015 |