Healthcare Provider Details

I. General information

NPI: 1144136714
Provider Name (Legal Business Name): MALEA VORAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 S WASHINGTON ST
MARION IN
46953-4974
US

IV. Provider business mailing address

4201 S WASHINGTON ST
MARION IN
46953-4974
US

V. Phone/Fax

Practice location:
  • Phone: 765-677-2318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36004214A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: