Healthcare Provider Details

I. General information

NPI: 1912843871
Provider Name (Legal Business Name): BOBBI BRYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HOSPITAL LN STE 200
DANVILLE IN
46122-1998
US

IV. Provider business mailing address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-745-3366
  • Fax: 317-745-8528
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-718-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71017896A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: