BRANDON ANDERSON AGACNP NPI 1043607369

NPI Information

NPI: 1043607369
Provider Name: BRANDON ANDERSON, AGACNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
8050 TOWNSHIP LINE RD
INDIANAPOLIS, IN
ZIP 46260
Phone: (317) 415-8500
Get Directions

Brandon Anderson, AGACNP is a gerontology nurse practitioner in Indianapolis, IN with 9 years of experience. Brandon Anderson, AGACNP NPI is 1043607369. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8050 TOWNSHIP LINE RD
INDIANAPOLIS, IN
ZIP 46260-478
Phone: (317) 415-8500

The NPI 1043607369 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/24/2015 and was last updated on 7/17/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	71005507A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	266180538	MEDICARE PIN	INDIANA
2	P01512410	OTHER	INDIANA	MEDICARE RR PTAN
3	201292680	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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