Dagen Gabriel Gene Fernandes

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · McCordsville, IN

NPI 1255250080 · NPPES record last updated Jul 14, 2026

Key facts

NPI
1255250080
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
9711 Highland Springs Dr N
McCordsville, IN 46055-9603
Phone
(317) 507-4516
NPI assigned
Jul 14, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X IN
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

9711 Highland Springs Dr N
McCordsville, IN 46055-9603

Mailing address

9711 Highland Springs Dr N
McCordsville, IN 46055-9603

Other providers in McCordsville, IN

All providers in McCordsville, IN · Student in an Organized Health Care Education/Training Program in Indiana

Sources for this page

Verify at the official NPI Registry.