Individual
HEATHER R UBERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 962-8776
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
71012985A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012985A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010856
MEDICARE PTAN
IN
01
—
1102691515
ANTHEM PTAN
IN
05
—
300069520
—
IN
Enumeration date
08/26/2022
Last updated
05/08/2024
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