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General NPI Number Information
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NPI Number | 1992095954
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Entity Type | Individual
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Provider Name | BRITTANY R NOWAK
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Gender | Female
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3307 W 96TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1106
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Country | US
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Telephone | 317-876-3699
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Fax | 317-674-0059
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Provider Business Mailing Address
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Address Line | 313 W WOLF POINT PLZ UNIT 5402
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City | CHICAGO
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State | IL
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Zip | 60654-8916
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Country | US
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Telephone | 765-894-1144
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 28188947A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71010009A
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License Number State | IN
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