Healthcare Provider Details

I. General information

NPI: 1013924224
Provider Name (Legal Business Name): SARA ELIZABETH BRAINERD NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10767 ILLINOIS ST STE 1300
CARMEL IN
46032-8972
US

IV. Provider business mailing address

PO BOX 781076
DETROIT MI
48278-1008
US

V. Phone/Fax

Practice location:
  • Phone: 317-528-2298
  • Fax: 317-528-2779
Mailing address:
  • Phone: 317-528-4800
  • Fax: 317-865-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71012131A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: