Individual
SUSAN BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
523 S STATE ROAD 67, MOORESVILLE, IN 46158-2792
(866) 389-2727
Mailing address
523 S STATE ROAD 67, MOORESVILLE, IN 46158-2792
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71014940A
IN
363LF0000X
Family Nurse Practitioner
71014940A
IN
Other
Enumeration date
02/14/2024
Last updated
01/09/2025
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