Healthcare Provider Details

I. General information

NPI: 1831492065
Provider Name (Legal Business Name): BRANDI A. KNEPLEY RN, MSN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 S BERKLEY RD
KOKOMO IN
46901-5114
US

IV. Provider business mailing address

8402 HARCOURT RD SUITE 400
INDIANAPOLIS IN
46260-2074
US

V. Phone/Fax

Practice location:
  • Phone: 765-236-8700
  • Fax: 765-236-8705
Mailing address:
  • Phone: 317-228-7000
  • Fax: 317-228-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71003504A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28134544A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: