Provider Demographics
NPI:1386923258
Name:UNIVERSITY OF INDIANAPOLIS
Entity type:Organization
Organization Name:UNIVERSITY OF INDIANAPOLIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V PRES. FOR BUS.& FINANCE AND TREAS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-788-3301
Mailing Address - Street 1:1400 E HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-3630
Mailing Address - Country:US
Mailing Address - Phone:317-788-3206
Mailing Address - Fax:317-788-6208
Practice Address - Street 1:1400 E HANNA AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-3630
Practice Address - Country:US
Practice Address - Phone:317-788-3206
Practice Address - Fax:317-788-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty