Provider Demographics
NPI:1821238478
Name:ANGIER, BRENDA KAY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:KAY
Last Name:ANGIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:KAY
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 SOUTH MERIDIAN STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-0397
Mailing Address - Country:US
Mailing Address - Phone:317-637-4343
Mailing Address - Fax:317-637-4344
Practice Address - Street 1:505 S 3RD ST
Practice Address - Street 2:SUITE 160
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-3252
Practice Address - Country:US
Practice Address - Phone:574-294-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28153599A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily