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Individual

SHANTAL HUCKABY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3200 SYCAMORE CT, COLUMBUS, IN 47203-1550
(812) 378-9027
(812) 378-1014
Mailing address
963 LAPWING DR, COLUMBUS, IN 47203-1923
(224) 433-0135

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
28206722C
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28206722A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28206722C
IN

Other

Enumeration date
05/09/2025
Last updated
05/12/2026
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