Healthcare Provider Details

I. General information

NPI: 1952329252
Provider Name (Legal Business Name): KATHRYN PAIGE BRINEGAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 WESTFIELD RD RIVERVIEW HOSPITAL
NOBLESVILLE IN
46060-1425
US

IV. Provider business mailing address

3333 KESSLER BLVD NORTH DR
INDIANAPOLIS IN
46222-1888
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-7407
  • Fax: 317-776-7361
Mailing address:
  • Phone: 317-328-2269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28129606A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: