Healthcare Provider Details

I. General information

NPI: 1659282010
Provider Name (Legal Business Name): EMMA WILLIAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N RONALD REAGAN PKWY
AVON IN
46123-7085
US

IV. Provider business mailing address

7310 STEINMEIER DR
INDIANAPOLIS IN
46250-2567
US

V. Phone/Fax

Practice location:
  • Phone: 317-217-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number28217647A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: