Healthcare Provider Details

I. General information

NPI: 1790619039
Provider Name (Legal Business Name): ABIGAIL LYNNE BRINKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15751 KOHUT LN
WESTFIELD IN
46074-6027
US

IV. Provider business mailing address

15751 KOHUT LN
WESTFIELD IN
46074-6027
US

V. Phone/Fax

Practice location:
  • Phone: 317-503-4708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28275360A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: