Individual provider Active NPI

Jenny Lynn Bravo, RN

  • Registered Nurse
  • Indianapolis, IN
National Provider Identifier
1497906382
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28181149A Issued in IN
Practice address
1481 W 10TH St
Indianapolis, IN 46202-2803
Phone
(317) 988-2328
NPI assigned
Oct 9, 2008
Last updated
Oct 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28181149A IN Primary

Addresses

Primary practice location

1481 W 10TH St
Indianapolis, IN 46202-2803

Mailing address

9041 Southernwood Way
Indianapolis, IN 46231-5255
Phone (317) 247-0115

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28181149AINMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1497906382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 SOUTHERNWOOD WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462315255",
            "telephone_number": "317-247-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28181149A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.