Healthcare Provider Details

I. General information

NPI: 1548595226
Provider Name (Legal Business Name): BROOKE ERIN HUBER MSN, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10255 COMMERCE DR STE 123
CARMEL IN
46032-7429
US

IV. Provider business mailing address

10255 COMMERCE DR STE 123
CARMEL IN
46032-7429
US

V. Phone/Fax

Practice location:
  • Phone: 765-969-0450
  • Fax: 317-456-0895
Mailing address:
  • Phone: 765-969-0450
  • Fax: 317-456-0895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71003048A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71003048A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: