Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71000070A | IN |
NPI | 1003865478 |
---|---|
Provider Name | Sue E Gaebler |
First Address | Indianapolis, IN 46268-6100 |
Second Address | Indianapolis, IN 46268-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 07/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200064210 | (05) | IN |
P72145 | (02) | IN |