Brackin, Diane Lynn

Brackin, Diane Lynn is an individual health care provider with primary practice located at 9894 E 121St St , Fishers IN 46037-4154. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Nursing Service Providers / Home Health. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Brackin, Diane Lynn can be contacted via phone (317) 621-4900.

Contact Information

Primary practice address
9894 E 121St St Fishers IN 46037-4154
Phone: (317) 621-4900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71005606A Indiana
Nursing Service Providers / Home Health 163WH0200X 28124384A Indiana

Profile Details

NPI number 1730579525
LBN Legal business name Brackin, Diane Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2015
Last updated Oct 12th, 2023 - about 2 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 1730579525 NPPES
Indiana Other P01512462 RR MEDICARE
Indiana MEDICAID 201313080 RR MEDICARE

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