Provider Demographics
NPI:1609280205
Name:HUBEL, LINDORA SUE (CNP)
Entity Type:Individual
Prefix:
First Name:LINDORA
Middle Name:SUE
Last Name:HUBEL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WATERMARK DR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1048
Mailing Address - Country:US
Mailing Address - Phone:614-645-5500
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:600 N PICKAWAY ST
Practice Address - Street 2:SUITE 300, MO BLDG.
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1447
Practice Address - Country:US
Practice Address - Phone:740-207-4202
Practice Address - Fax:740-207-4221
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA16005NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0106559Medicaid
OHH347905Medicare PIN
OHH347906Medicare PIN
OHH347907Medicare PIN
OHH347904Medicare PIN
OHH347901Medicare PIN
OH0106559Medicaid
OHH347900Medicare PIN
OHH347908Medicare PIN