Individual
BARBARA J BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC WHNP
Contact information
Practice address
1419 W BELLA DR, MARION, IN 46953-5250
(765) 660-7580
(765) 664-0469
Mailing address
330 NORTH WABASH AVENUE, SUITE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71000474A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343049
ANTHEM BCBS
IN
05
—
100411290Z
—
IN
Enumeration date
11/09/2005
Last updated
08/01/2013
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