Individual
LAURIEJO HALL CUETO-ARREOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-9515
(812) 353-9275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100433840
MEDICAID GROUP
IN
05
—
300009743
—
IN
Enumeration date
12/22/2008
Last updated
01/11/2023
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