Healthcare Provider Details

I. General information

NPI: 1811814403
Provider Name (Legal Business Name): FAATIN A ECTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 N LIBERTY ST STE 126
JACKSON TN
38301-6221
US

IV. Provider business mailing address

1935 DEVA CIR
INDIANAPOLIS IN
46228-2367
US

V. Phone/Fax

Practice location:
  • Phone: 317-669-6789
  • Fax: 323-704-3043
Mailing address:
  • Phone: 317-518-4909
  • Fax: 323-704-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: