Provider Demographics
NPI:1699513804
Name:NNATUBEUGO, BIBIAN U U
Entity type:Individual
Prefix:
First Name:BIBIAN U
Middle Name:U
Last Name:NNATUBEUGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 ROCKY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7762
Mailing Address - Country:US
Mailing Address - Phone:317-903-0067
Mailing Address - Fax:
Practice Address - Street 1:488 ROCKY MEADOW DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7762
Practice Address - Country:US
Practice Address - Phone:317-903-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24-016262253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care