Connie A Bronson
Individual provider Active NPI Family Nurse Practitioner · Bedford, IN
NPI 1922521608 · NPPES record last updated Sep 13, 2022
Key facts
- NPI
- 1922521608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71007448A (IN)
- Practice address
- 1141 16TH St
Bedford, IN 47421-3721 - Phone
- (574) 536-8874
- NPI assigned
- Jul 25, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170920000716 | IN | Practitioner - Nurse Practitioner | 3476827122 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007448A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71007448A | IN | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71007448A | IN |
Addresses
Primary practice location
1141 16TH St
Bedford, IN 47421-3721
Mailing address
13090 Petigru Dr
Carmel, IN 46032-4436
Phone (317) 733-8608
Other providers in Bedford, IN
- Marianna Brashear
- Richard Westen Breeding
- Christina Breitweiser
- Bree Breton
- Bright Paths Counseling LLC
- Lynn Marie Brooking
- Merrin J Brown
- Tricia Brown
- Caroline M Browne
- Buch Chiropractic Inc
All providers in Bedford, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.