Provider Demographics
NPI:1841244084
Name:BRANSON, CARLA J (NP/APN)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:J
Last Name:BRANSON
Suffix:
Gender:F
Credentials:NP/APN
Other - Prefix:MRS
Other - First Name:CARLA
Other - Middle Name:J
Other - Last Name:POTTSCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP/APN
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 1:3333 BURNETT AVE.
Practice Address - Street 2:CINCINNATI CHILDRENS HOSPITAL CREDENTIALING
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:317-826-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001541A2084P0804X
OHAPRN.CNP.12371363L00000X
IN1841244084363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner