Healthcare Provider Details

I. General information

NPI: 1851206163
Provider Name (Legal Business Name): HAILEY JANE FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 S AVON AVE
AVON IN
46123-8661
US

IV. Provider business mailing address

3106 W NEW YORK ST
INDIANAPOLIS IN
46222-4661
US

V. Phone/Fax

Practice location:
  • Phone: 317-544-5800
  • Fax:
Mailing address:
  • Phone: 989-858-3616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: