Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 71009978A | IN |
NPI | 1023638244 |
---|---|
Provider Name | Taylor Schub |
First Address | Carmel, IN 46032-3950 |
Second Address | Carmel, IN 46032-1581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2020 |
Last Update Date | 19/10/2021 |