ABBY JO BRACK (NPI# 1104399013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104399013 |
Entity Type | Individual |
Full Name | ABBY JO BRACK |
Credential | NP |
Practice Address |
2920 N Arlington Ave Indianapolis IN 46218-3361 |
Mailing Address |
6626 E 75th St Ste 500 Indianapolis IN 46250-2890 |
Practice Telephone | 3173559315 |
Practice Fax Number | 3173559319 |
Mailing Telephone | 3176217547 |
Enumeration Date | 2019-01-03 |
Last Update Date | 2020-09-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
28146639A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 300022477 | 05 |
Street Address |
2920 N ARLINGTON AVE |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46218-3361 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124043716 | Community Hospitals of Indiana Inc | Family Medicine | 2920 N Arlington Ave, Suite B, Indianapolis, IN 46218-3362 | 2006-07-13 |
1013473297 | Patricia Justine Irvin | Nurse Practitioner | 2920 N Arlington Ave, Indianapolis, IN 46218-3361 | 2019-02-13 |
1124040464 | L T Gates | Family Medicine | 2920 N Arlington Ave, Suite B, Indianapolis, IN 46218-3362 | 2006-07-24 |
1194745208 | Mary P Blanchet | Nurse Practitioner | 2920 N Arlington Ave, Suite B, Indianapolis, IN 46218-3362 | 2006-07-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487208930 | Darryl K Webster | Counselor | 4901 E. 31st Street, Indianapolis, IN 46218 | 2019-08-01 |
1780238238 | Rhonda Y. Battles | Counselor | 1775 N Sherman Dr Suite A, Indianapolis, IN 46218 | 2019-08-01 |
1861918849 | Corey Simmons | Ambulance | 3659 N Temple Ave, Indianapolis, IN 46218 | 2017-08-21 |
1245769645 | Community Health Network, Inc | Clinic/Center | 1640 N. Ritter Avenue, Indianapolis, IN 46218 | 2017-06-08 |
1912221615 | Melvin Lowell Stringer Jr. | Driver | 3266 N. Arsenal Ave, Indianapolis, IN 46218 | 2010-03-24 |
1952523854 | Allyson Leigh Mcintire | Counselor | 5502 E 16 Th Street, Indpls, IN 46218 | 2007-05-02 |
1104912963 | Andrea Sue Campbell | Social Worker | 5502 E 16th Street, Indpls, IN 46218 | 2006-10-05 |
1720186356 | Abbie Ann Grudzien | Counselor | 4701 N Keystone, Ste 150, Indpls, IN 46218 | 2006-09-20 |
1508978784 | Linda A Fundenberger | Ophthalmology | 2815 E 38th Street, Indianapolis, IN 46218 | 2006-08-31 |
1063467850 | Aaron P Kalinowski | Emergency Medicine | 2920 N Arlington Ave Ste B, Indianapolis, IN 46218 | 2006-05-23 |
Find all providers in zip 46218 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
1922614965 | Children Express Care Clinic LLC | Nurse Practitioner | 5435 Emerson Way Ste 110, Indianapolis, IN 46226-1470 | 2020-09-16 |
1255956272 | Heather Nicole Zore | Nurse Practitioner | 9240 N Meridian St Ste 225, Indianapolis, IN 46260-1880 | 2020-06-15 |
1457976615 | Adam Weir | Nurse Practitioner | 960 E Washington St, Indianapolis, IN 46202-3981 | 2020-06-13 |
1457975740 | Ayee Teah Bleemie | Nurse Practitioner | 429 E Vermont St Ste 100, Indianapolis, IN 46202-3688 | 2020-06-02 |
1689294357 | May Josefa Ishikawa | Nurse Practitioner | 705 Riley Hospital Dr Ste 2240, Indianapolis, IN 46202-5109 | 2020-04-22 |
1760001200 | John Shaver | Nurse Practitioner | 3750 N Meridian St Ste 100, Indianapolis, IN 46208-4300 | 2020-04-14 |
1851931000 | Robin L Petit | Nurse Practitioner | 6925 S Harding St Ste B-1, Indianapolis, IN 46217-4114 | 2020-01-15 |
1952941577 | Andreya Beckett | Nurse Practitioner | 3500 Depauw Blvd Ste 1041, Indianapolis, IN 46268-6125 | 2020-01-11 |
1053950105 | Shannon Malecki | Nurse Practitioner | 550 University Blvd Ste 5630, Indianapolis, IN 46202-5149 | 2020-01-06 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46218 |
Please comment or provide details below to improve the information on ABBY JO BRACK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.