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Individual

SHARON M HUBBARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
642 W HOSPITAL RD, PAOLI, IN 47454-9672
(812) 723-2811
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28101953A
IN
367500000X
Certified Registered Nurse Anesthetist
3003872
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000283663
BLUE SHIELD
KY
01
163460034
MEDICARE
IN
05
200515430
IN
01
2783438000
PASSPORT ADVANTAGE
KY
01
430079779
RAILROAD MEDICARE
01
50012803
PASSPORT
KY
05
7100110280
KY
Enumeration date
10/04/2005
Last updated
03/01/2023
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