Provider Demographics
NPI:1649352659
Name:STEPHENS BIBEAU, PAULA K (RNC CNM)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:K
Last Name:STEPHENS BIBEAU
Suffix:
Gender:F
Credentials:RNC CNM
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Mailing Address - Street 1:1100 SOUTHFIELD DR STE 1370
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4300
Mailing Address - Country:US
Mailing Address - Phone:317-837-5566
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:112 HOSPITAL LN STE 200
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1998
Practice Address - Country:US
Practice Address - Phone:317-745-3366
Practice Address - Fax:317-745-8528
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-03-12
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Provider Licenses
StateLicense IDTaxonomies
IN72000005B367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100419730Medicaid