Provider Demographics
NPI:1831492065
Name:KNEPLEY, BRANDI A (RN, MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:A
Last Name:KNEPLEY
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 HARCOURT RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2074
Mailing Address - Country:US
Mailing Address - Phone:317-228-7000
Mailing Address - Fax:317-228-9029
Practice Address - Street 1:307 S BERKLEY RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-5114
Practice Address - Country:US
Practice Address - Phone:765-236-8700
Practice Address - Fax:765-236-8705
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003504A363L00000X
IN28134544A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000700271OtherANTHEM
IN201014460Medicaid
IN9596655OtherAETNA
IN000000700271OtherANTHEM