Brenda Davis

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

28171562A Issued in IN

Practice address

111 W 10TH St
Hobart, IN 46342-5990

Phone

(219) 670-3148

Fax

(219) 844-3578

NPI assigned

Jun 26, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1285862300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 10TH ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463425990",
            "telephone_number": "219-670-3148",
            "fax_number": "219-844-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 10TH ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463425990",
            "telephone_number": "219-670-3148",
            "fax_number": "219-844-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENDA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28171562A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Crum, CNM
• Morgan Cullings, FNP
• Cyanic Corporate Solutions, Corp.
• Hung Dang, DO
• David G. Gross, D.O., P.C.
• Douglas C Dedelow, DO
• Deepak G Bhojraj M.D. Inc.
• Jeanne Antoinette Degrazia, D.D.S.
• Joseph A Dejoan, M.D.
• Nico Renzo Del Piccolo, MD

• Nurse Practitioner in Hobart, IN
• Providers in Hobart, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.