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General NPI Number Information
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NPI Number | 1063412419
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Entity Type | Individual
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Provider Name | DEBRA K BRANDENBERGER NP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1100 MERCER AVE
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City | DECATUR
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State | IN
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Zip | 46733-2303
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Country | US
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Telephone | 260-724-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 2518 E DUPONT RD
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City | FORT WAYNE
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State | IN
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Zip | 46825-1675
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Country | US
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Telephone | 260-432-4400
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Fax | 260-969-6833
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 71000773A
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License Number State | IN
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