Individual
TABITHA MARIE HUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-4779
(317) 948-9806
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71013426A
IN
363LP0200X
Pediatric Nurse Practitioner
71013426A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185720024
MEDICARE
IN
05
—
300071696
—
IN
Enumeration date
12/28/2022
Last updated
04/06/2023
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