Healthcare Provider Details

I. General information

NPI: 1427989342
Provider Name (Legal Business Name): SARINNA BRUECKNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 MICHIGAN RD
INDIANAPOLIS IN
46268-1915
US

IV. Provider business mailing address

7911 MICHIGAN RD
INDIANAPOLIS IN
46268-1915
US

V. Phone/Fax

Practice location:
  • Phone: 317-956-6288
  • Fax:
Mailing address:
  • Phone: 317-956-6288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1241775
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1241775
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: