Provider Demographics
NPI:1164699559
Name:GRAHAM-WOOD, BRANDI ANN (MIDWIFE, CDEM, CPM)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:ANN
Last Name:GRAHAM-WOOD
Suffix:
Gender:F
Credentials:MIDWIFE, CDEM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12840 FORD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2894
Mailing Address - Country:US
Mailing Address - Phone:765-643-9433
Mailing Address - Fax:765-250-9389
Practice Address - Street 1:12840 FORD DR STE 100
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2894
Practice Address - Country:US
Practice Address - Phone:765-643-9433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN90000003A176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife