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General NPI Number Information
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NPI Number | 1912988676
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Entity Type | Individual
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Provider Name | BARBARA J BRAGG RNC WHNP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 1419 W BELLA DR
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City | MARION
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State | IN
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Zip | 46953-5250
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Country | US
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Telephone | 765-660-7580
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Fax | 765-664-0469
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Provider Business Mailing Address
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Address Line | 330 NORTH WABASH AVENUE SUITE G20
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City | MARION
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State | IN
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Zip | 46952-2600
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Country | US
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Telephone | 765-660-7600
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Fax | 765-651-7313
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 71000474A
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License Number State | IN
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