DIANE LYNN BRACKIN NP NPI 1730579525

NPI Information

NPI: 1730579525
Provider Name: DIANE LYNN BRACKIN, NP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
9894 E 121ST ST
FISHERS, IN
ZIP 46037
Phone: (317) 621-4900
Get Directions

Diane Lynn Brackin, NP is a gerontology nurse practitioner in Fishers, IN with 9 years of experience. Diane Lynn Brackin, NP NPI is 1730579525. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9894 E 121ST ST
FISHERS, IN
ZIP 46037-154
Phone: (317) 621-4900

The NPI 1730579525 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 1/31/2015 and was last updated on 10/12/2023.

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	71005606A	INDIANA	Yes
2	163WH0200X	Registered Nurse	Home Health	28124384A	INDIANA	No

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	P01512462	OTHER	INDIANA	RR MEDICARE
2	201313080	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: 5/5/2024

NPI Synchronization or Removal

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