MEDICARE: CARMEN MERRIWEATHER MEDICAL ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	48-01-04-05216	IN
2	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1164694345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN MERRIWEATHER MEDICAL ASSISTANT

Provider Business Mailing Address
First Line	:	7007 GRAHAM RD STE 218
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4047
Country	:	US
Telephone Number	:	317-820-3565
Fax Number	:	317-820-3565

Provider Business Practice Location Address
First Line	:	7007 GRAHAM ROAD
Second Line	:	SUITE 218
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4047
Country	:	US
Telephone Number	:	317-820-3565
Fax Number	:	317-820-3565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2008
Last Update Date	:	02/16/2026

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