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General NPI Number Information
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NPI Number | 1760216931
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Entity Type | Individual
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Provider Name | MISS BRIANA SURRETT
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Gender | Female
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Dates
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Enumeration Date | 08/29/2024
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 5625 SUNNYSIDE RD STE 102
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-8513
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Country | US
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Telephone | 463-328-8862
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 N SUNNYSIDE RD SUITE 102
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-8513
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Country | US
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Telephone | 463-328-8862
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Fax |
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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 | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | 240179971
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 24-017997-1
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 240179971
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License Number State | IN
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