MEDICARE: HALEY MARIE CHILDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	104865229	IN

General Provider Information

NPI Number	:	1528881125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY MARIE CHILDERS

Provider Business Mailing Address
First Line	:	5762 HENDERSON DR
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-8681
Country	:	US
Telephone Number	:	317-853-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	5762 HENDERSON DR
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-8681
Country	:	US
Telephone Number	:	812-372-1581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	03/12/2026

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Directions to “ HALEY MARIE CHILDERS ” Practice Location

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