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General NPI Number Information
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NPI Number | 1578230967
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Entity Type | Individual
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Provider Name | MALICHIA DENISE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 1635 N ARLINGTON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-5181
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Country | US
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Telephone | 317-353-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 3850 BURNINGBUSH DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-3583
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Country | US
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Telephone | 317-509-9937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 27058912A
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License Number State | IN
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