MEDICARE: DR. KATHERINE NICOLE BRADNER PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	26022559A	IN

General Provider Information

NPI Number	:	1285874586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE NICOLE BRADNER PHARM. D.

Provider Business Mailing Address
First Line	:	950 N MERIDIAN ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1077
Country	:	US
Telephone Number	:	317-963-0377
Fax Number	:	317-962-4070

Provider Business Practice Location Address
First Line	:	950 N MERIDIAN ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1077
Country	:	US
Telephone Number	:	317-963-0377
Fax Number	:	317-962-4070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	02/26/2009

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