Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Matthew Anthony Hettenbach, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1003430729

Matthew Anthony Hettenbach, PMHNP is a Nurse Practitioner in Racine, Wisconsin. Qualified in 2020, 6 years ago. Practices with Ascension Medical Group-Southeast Wisconsin Inc, a 555-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

1244 Wisconsin Ave
Racine, WI 53403-1987
Phone: (262) 687-2956
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 10089 (WI)

Record details

NPI number1003430729
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedMay 29, 2020
Last updated in NPPESMay 29, 2020
Certification dateMay 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ascension Medical Group-Southeast Wisconsin Inc — 555 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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