Individual
BRENDA R RUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13100 E 136TH ST, STE 1200, FISHERS, IN 46037-9418
(317) 678-3100
(317) 678-3108
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28181996A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002896A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201138290
—
IN
Enumeration date
04/07/2009
Last updated
01/20/2015
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