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Individual

SANDRA MICHELLE BRATTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D

Contact information

Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2479
(765) 448-8000
(765) 448-8335
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002097A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000190209
ANTHEM PROVIDER NUMBER
IN
01
9397756
PHCS PID NUMBER
IN
Enumeration date
03/23/2006
Last updated
07/16/2007
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