Individual
BETHANY JANE LUBENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
613 DORBETT STREET, JASPER, IN 47546-2615
(812) 481-2229
(812) 482-3993
Mailing address
613 DORBETT STREET, JASPER, IN 47546-2615
(812) 481-2229
(812) 482-3993
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001172A
IN
363AS0400X
Surgical Physician Assistant
10001172A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015512
—
IN
Enumeration date
01/24/2008
Last updated
01/09/2025
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