Healthcare Provider Details

I. General information

NPI: 1255861688
Provider Name (Legal Business Name): BROOK NICOLE CAHILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOK NICOLE MUNGER MD

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 BARNHILL DR
INDIANAPOLIS IN
46202-5112
US

IV. Provider business mailing address

1646 BEACH ST
GREENWOOD IN
46143-5009
US

V. Phone/Fax

Practice location:
  • Phone: 317-278-0394
  • Fax:
Mailing address:
  • Phone: 317-902-6526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number01093687A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: