Healthcare Provider Details

I. General information

NPI: 1861305484
Provider Name (Legal Business Name): AVALON INTEGRATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7818 REYNOLDS RD
CAMBY IN
46113-9311
US

IV. Provider business mailing address

7818 REYNOLDS RD
CAMBY IN
46113-9311
US

V. Phone/Fax

Practice location:
  • Phone: 317-296-4322
  • Fax: 317-854-9088
Mailing address:
  • Phone: 317-296-4322
  • Fax: 317-854-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGIE NICOLE BROWN
Title or Position: OWNER/NURSE PRACTITIONER
Credential: NP
Phone: 317-903-6700