Brackin, Diana Louise

Brackin, Diana Louise is an individual health care provider with primary practice located at 600 S Jackson Park Dr , Seymour IN 47274-2626. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Brackin, Diana Louise can be contacted via phone (812) 519-2963.

Contact Information

Primary practice address
600 S Jackson Park Dr Seymour IN 47274-2626
Phone: (812) 519-2963
Fax: (812) 519-3515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71001567A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71001567A Indiana

Profile Details

NPI number 1972578474
LBN Legal business name Brackin, Diana Louise
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Jun 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972578474 NPPES
Indiana MEDICAID 200537140
Indiana Other 000000652123

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