Individual
BRANDY JO MCCLAUGHRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303
(260) 969-1950
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28157189A
IN
363L00000X
Nurse Practitioner
71002848A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002848A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000609123
ANTHEM BC/BS
IN
01
—
000000626639
ANTHEM BC/BS
IN
01
—
000000659985
ANTHEM BC/BS
IN
05
—
200935360
—
IN
01
—
P00719994
RAILROAD MEDICARE
IN
01
—
P00742234
RAILROAD MEDICARE
IN
Enumeration date
11/04/2008
Last updated
10/28/2020
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