Healthcare Provider Details

I. General information

NPI: 1467963348
Provider Name (Legal Business Name): ALEXIS BRUMFIELD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHFIELD DR STE 1140
PLAINFIELD IN
46168-4499
US

IV. Provider business mailing address

1100 SOUTHFIELD DR STE 1370
PLAINFIELD IN
46168-4300
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-7200
  • Fax: 317-837-7926
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-837-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71014836A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209016681
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier209016681
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerAPN LICENSE
# 2
Identifier300119209
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer
# 3
Identifier71014836A
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: