Provider Demographics
NPI:1184214892
Name:CAIN, BRENDA (RN,BSN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CAIN
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9842 HERALD SQ
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-8852
Mailing Address - Country:US
Mailing Address - Phone:317-435-8097
Mailing Address - Fax:317-863-1413
Practice Address - Street 1:5519 E 82ND ST STE D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4516
Practice Address - Country:US
Practice Address - Phone:317-436-8133
Practice Address - Fax:317-863-1413
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28225472A163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health