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DIANE L BRACKIN, NP – NPI #1730579525
Gerontology

NPI Profile for DIANE L BRACKIN in FISHERS, IN.

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Contact Information

DIANE L BRACKIN, NP
9894 E 121ST ST
FISHERS, IN  46037-4154
 Phone: 317-621-4900
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Gerontology

 363LG0600X 50 Nurse Practitioner
 

Home Health

 163WH0200X
Indicates primary specialty

NPI Profile & details for DIANE L BRACKIN · (Female)

NPI # 1730579525
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 01/31/2015
Last updated 10/12/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 28124384A
  • IN License # 71005606A
  • IN Medicaid 201313080
  • IN Other P01512462 RR MEDICARE
Hospital affiliation(s)
  • COMMUNITY HOSPITAL EAST - (Acute Care)
    1500 N RITTER AVE
    INDIANAPOLIS, IN 46219
  • COMMUNITY HOSPITAL SOUTH - (Acute Care)
    1402 E COUNTY LINE RD S
    INDIANAPOLIS, IN 46227
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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