Individual
HAILEY M PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 944-3636
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28237581A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009909A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074790078
MEDICARE
IN
05
—
300037822
—
IN
Enumeration date
03/12/2020
Last updated
02/24/2023
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