Individual provider · Type 1 NPI

Matthew Anthony Hettenbach, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Racine, WI

NPI number 1003430729 Active

Practice location

1244 Wisconsin Ave
Racine, WI 53403-1987

Mailing address

2019 Saint Clair St
Racine, WI 53402-4763

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X10089 (WI)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X10089 (WI)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1003430729

Matthew Anthony Hettenbach, PMHNP's National Provider Identifier is 1003430729, issued on May 29, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Racine, WI. The record was last updated on Sep 24, 2026.