Provider Demographics
NPI:1184459679
Name:DAWKINS, BRANDI (HOME CARE)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:HOME CARE
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:DAWKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAVISH LIVING
Mailing Address - Street 1:8555 RIVER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-4304
Mailing Address - Country:US
Mailing Address - Phone:317-682-8413
Mailing Address - Fax:
Practice Address - Street 1:8555 RIVER RD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-4304
Practice Address - Country:US
Practice Address - Phone:317-682-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
IN24-016546-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion