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NPI 1750311809

NPI 1750311809 : LAURA H NUTTER M.D. : HANOVER, IN

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General NPI Number Information
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    NPI Number           |    1750311809
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    Entity Type          |    Individual 
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    Provider Name        |    LAURA H NUTTER M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/04/2006
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    Last Update Date     |    02/20/2019
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Provider Practice Location Address
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    Address Line         |    36 MEDICAL PLZ 
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    City                 |    HANOVER
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    State                |    IN
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    Zip                  |    47243
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    Country              |    US
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    Telephone            |    812-866-3301
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    Fax                  |    812-866-3327
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Provider Business Mailing Address
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    Address Line         |    PO BOX 3395 
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    City                 |    EVANSVILLE
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    State                |    IN
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    Zip                  |    47732-3395
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    01056198
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    License Number State |    IN
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