Sharon Tutlewski, FNP
Individual provider Active NPI Family Nurse Practitioner · Lake Station, IN
NPI 1558475855 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1558475855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71000150 (IN)
- Practice address
- 2490 Central Ave
Lake Station, IN 46405-2122 - Phone
- (219) 962-2760
- Fax
- (219) 962-1757
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000150 | IN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000150 | IN | Yes |
Addresses
Primary practice location
2490 Central Ave
Lake Station, IN 46405-2122
Mailing address
2490 Central Ave
Lake Station, IN 46405-2122
Phone (219) 962-2760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200331760 | Medicaid | IN |
Other providers in Lake Station, IN
- John A Sobolewski
- Southlake Tricity Rba
- Dakota Lynn Taylor
- Rebecca Thimothy
- Patience Tieri
- Walgreen Co
All providers in Lake Station, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.