Individual provider Active NPI

Brittany R Nowak

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1992095954
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71010009A Issued in IN
Practice address
3307 W 96TH St
Indianapolis, IN 46268-1106
Phone
(317) 876-3699
Fax
(317) 674-0059
NPI assigned
Apr 12, 2011
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71010009A IN Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 28188947A IN

Addresses

Primary practice location

3307 W 96TH St
Indianapolis, IN 46268-1106

Mailing address

313 W Wolf Point PLZ Unit 5402
Chicago, IL 60654-8916
Phone (765) 894-1144

Other practice location 1

8770 Guion Rd
Indianapolis, IN 46268-3042
Phone (317) 648-2887

Other practice location 2

7322 Noel Rd
Indianapolis, IN 46278-1515
Phone (877) 659-4555

Other identifiers 1

IdentifierTypeStateIssuer
71010009AOtherINLICENSE NO.

Other names 1

  • Brittany Neal Former name

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)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
71010009AINMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1992095954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W WOLF POINT PLZ UNIT 5402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606548916",
            "telephone_number": "765-894-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 W 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681106",
            "telephone_number": "317-876-3699",
            "fax_number": "317-674-0059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8770 Guion Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462683042",
            "country_code": "US",
            "telephone_number": "317-648-2887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7322 Noel Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462781515",
            "country_code": "US",
            "telephone_number": "877-659-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "BRITTANY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71010009A",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28188947A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "71010009A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "NEAL",
            "credential": "PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 1, 2024; 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.