Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 01064846A | IN |
NPI | 1023285335 |
---|---|
Provider Name | Hannah Michaele Huddleston |
First Address | Indianapolis, IN 46240-0028 |
Second Address | Carmel, IN 46032-4694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 15/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061500V | (02) | IN |