MEDICARE: SUE E GAEBLER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71000070A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003865478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUE E GAEBLER NP

Provider Business Mailing Address
First Line	:	8910 PURDUE RD
Second Line	:	STE.500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-6100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6940 MICHIGAN RD
Second Line	:	STE 140
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2800
Country	:	US
Telephone Number	:	317-266-2901
Fax Number	:	317-266-2912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/07/2010

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Directions to “ SUE E GAEBLER NP” Practice Location

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