Individual
NICOLE A SHIBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HSPP
Contact information
Practice address
427 W EADS PKWY, LAWRENCEBURG, IN 47025-1139
(812) 537-7375
Mailing address
285 BIELBY RD, LAWRENCEBURG, IN 47025-1055
(812) 537-1302
(812) 537-5219
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042004A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354554
BLUE SHIELD
IN
05
—
200524930
—
IN
Enumeration date
01/18/2007
Last updated
07/09/2007
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