Healthcare Provider Details
I. General information
NPI: 1316180144
Provider Name (Legal Business Name): BRADEN M BUTTERFIELD MCKINLEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2009
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8888 KEYSTONE XING STE OFC1382
INDIANAPOLIS IN
46240-4609
US
IV. Provider business mailing address
1359 S RANDOLPH ST
GARRETT IN
46738-1970
US
V. Phone/Fax
- Phone: 888-998-7337
- Fax:
- Phone: 260-357-0077
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 28159267A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 71002917A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: