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General NPI Number Information
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NPI Number | 1013924224
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Entity Type | Individual
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Provider Name | SARA ELIZABETH BRAINERD NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1310 LEBANON STREET
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City | LEBANON
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State | IN
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Zip | 46052-3076
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Country | US
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Telephone | 765-482-7005
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Fax | 765-483-2517
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Provider Business Mailing Address
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Address Line | 1310 S LEBANON ST
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City | LEBANON
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State | IN
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Zip | 46052-3076
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Country | US
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Telephone | 765-482-7005
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Fax | 765-483-2517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG06210272
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License Number State | IN
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