Healthcare Provider Details

I. General information

NPI: 1508168196
Provider Name (Legal Business Name): KAITLIN M. BRAUN RN, MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLIN ROWLAND

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 02/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9669 E 146TH ST SUITE 100
NOBLESVILLE IN
46060-5006
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-3434
  • Fax: 317-621-3430
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15405
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003915A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: