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Individual
SALLY A SCHUCK
Active
Individual
SALLY A SCHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002562A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000546681
ANTHEM PIN - MARY ST
IN
01
—
000000547016
ANTHEM - GATEWAY BLVD
IN
Enumeration date
12/07/2007
Last updated
04/10/2008
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