Provider Demographics
NPI:1982834370
Name:CARR-VOGELGESANG, BRENDA LEE (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:CARR-VOGELGESANG
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8150 OAKLANDON RD STE 130
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9554
Practice Address - Country:US
Practice Address - Phone:317-621-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28164681A163W00000X
IN71002981A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000640747OtherANTHEM PROVIDER NUMBER
IN200958630Medicaid
INP01214612OtherMEDICARE RAILROAD
IN266180578Medicare PIN
IN200958630Medicaid
INM400038577Medicare PIN
IN815500BBB4Medicare PIN
INM400038639Medicare PIN
INM400038681Medicare PIN
INP00782473Medicare PIN
INM400038587Medicare PIN
INM400053533Medicare PIN
INM400038648Medicare PIN
INM400027390Medicare PIN
INP01214612OtherMEDICARE RAILROAD
IN265900KMedicare PIN