Provider Demographics
NPI:1952304040
Name:BRASHEAR, JANICE L (ARNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:BRASHEAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-285-8392
Practice Address - Street 1:510 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-285-8392
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001473A363LP0808X
KY3003537363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
50704000OtherMAGELLAN GROUP MIS
580397000OtherMAGELLEN MIS #
INCG2274OtherMEDICARE RAILROAD GROUP
IN200298400AMedicaid
KY82900176Medicaid
KY2444451000OtherPASSPORT GROUP
KY65927857Medicaid
KY6764OtherMEDICARE GROUP
000000056294OtherANTHEM GROUP #
IN100386460OtherINDIANA MEDICAID GROUP
IN160780OtherMEDICARE GROUP
IN160860OtherMEDICARE GROUP
KYCK2274OtherRAILROAD MEDICARE GROUP
KYP00065495OtherMEDICARE RAILROD
KY78009404Medicaid
000000303817OtherANTHEM
KY2444453000OtherPASSPORT ADVANTAGE
1487872636OtherNPI GROUP NUMBER (ARNP)
KY78903689Medicaid
INP00455002OtherRAILROAD MEDICARE
KYP00065495OtherMEDICARE RAILROD
KY2444453000OtherPASSPORT ADVANTAGE
IN160780VMedicare PIN