=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699223461
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WORLD CHANGING NURSES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2016
-----------------------------------------------------
Last Update Date | 09/21/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1030 S MITCHNER AVE
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46239-1160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-694-7422
-----------------------------------------------------
Fax | 317-351-0540
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1030 S MITCHNER AVE
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46239-1160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-694-7422
-----------------------------------------------------
Fax | 317-351-0540
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MELISSA BROCK
-----------------------------------------------------
Credential | ANPC
-----------------------------------------------------
Telephone | 317-694-7422
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------