Healthcare Provider Details

I. General information

NPI: 1750220703
Provider Name (Legal Business Name): BRIANA HAYNES MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S GOPHER DR
FRANKFORT IN
46041-6800
US

IV. Provider business mailing address

5633 W GAS LINE RD
FRANKFORT IN
46041-7356
US

V. Phone/Fax

Practice location:
  • Phone: 765-650-7875
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018301A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28183879A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: