Provider Demographics
NPI:1215908538
Name:BROWNING, TAMMY MICHELLE CRACE (PA-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MICHELLE CRACE
Last Name:BROWNING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:CRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5256 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4819
Mailing Address - Country:US
Mailing Address - Phone:317-429-0120
Mailing Address - Fax:317-800-7730
Practice Address - Street 1:5256 E 65TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4819
Practice Address - Country:US
Practice Address - Phone:317-429-0120
Practice Address - Fax:866-202-5499
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA483363AM0700X
IN10001016A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000581231OtherBCBS
KY1208007OtherMEDICARE INDIVIDUAL PROVI
KYP00655066OtherRAILROAD MEDICARE PIN
KY0928408Medicare PIN
IN247380DMedicare PIN