Individual
BRAXTON R SHIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
8205 E 56TH ST STE 100, INDIANAPOLIS, IN 46216-1069
(317) 621-1006
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012197A
IN
Other
Enumeration date
02/01/2022
Last updated
05/05/2025
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