Healthcare Provider Details

I. General information

NPI: 1568715431
Provider Name (Legal Business Name): SARAH TOEBBE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 02/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GREENBUSH ST
LAFAYETTE IN
47904-2477
US

IV. Provider business mailing address

2600 GREENBUSH ST
LAFAYETTE IN
47904-2477
US

V. Phone/Fax

Practice location:
  • Phone: 765-448-8000
  • Fax:
Mailing address:
  • Phone: 765-448-8000
  • Fax: 765-448-8227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28180133A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71004257A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: