Individual
MR. DANA G. BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002064A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200808410
—
IN
Enumeration date
03/01/2006
Last updated
09/03/2024
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