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General NPI Number Information
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NPI Number | 1861307340
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Entity Type | Organization
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Legal Business Name | STATE OF INDIANA: INDIANA DEPARTMENT OF CORRECTION
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 302 W WASHINGTON ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46204
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Country | US
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Telephone | 317-233-6984
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Fax |
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Provider Business Mailing Address
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Address Line | 302 W WASHINGTON ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46204
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Country | US
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Telephone | 317-233-6984
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | CHERRIE L. OLSON
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Credential |
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Telephone | 317-698-0093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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