Healthcare Provider Details

I. General information

NPI: 1619732112
Provider Name (Legal Business Name): BERNADETTE MARY SCHRIML PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BERNADETTE HUGHBANKS PA-C

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7979 N SHADELAND AVE STE 200
INDIANAPOLIS IN
46250-2042
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-3300
  • Fax: 317-621-6601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10005436A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008673RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: