Healthcare Provider Details

I. General information

NPI: 1609280205
Provider Name (Legal Business Name): LINDORA SUE HUBEL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N PICKAWAY ST SUITE 300, MO BLDG.
CIRCLEVILLE OH
43113-1447
US

IV. Provider business mailing address

1800 WATERMARK DR SUITE 420
COLUMBUS OH
43215-1048
US

V. Phone/Fax

Practice location:
  • Phone: 740-207-4202
  • Fax: 740-207-4221
Mailing address:
  • Phone: 614-645-5500
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA16005NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: