Provider Demographics
NPI:1487209284
Name:PICKERELL, BRITTANY B (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:B
Last Name:PICKERELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:B
Other - Last Name:SHIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:535 BARNHILL DR STE 420
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5116
Practice Address - Country:US
Practice Address - Phone:317-948-3098
Practice Address - Fax:317-944-0174
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009190A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001303608OtherANTHEM
IN064740047OtherMEDICARE
IN300029444Medicaid