Healthcare Provider Details

I. General information

NPI: 1699202879
Provider Name (Legal Business Name): BROOKE SCHAEFER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 E 1000 S
PENDLETON IN
46064-8969
US

IV. Provider business mailing address

1546 E 1000 S
PENDLETON IN
46064-8969
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax: 317-669-8217
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007182A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71007182A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28173979A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: