MEDICARE: HAILLEY PEARL BOUWERS

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	163W00000X	Registered Nurse	28268933A	IN

General Provider Information

NPI Number	:	1346113743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILLEY PEARL BOUWERS

Provider Business Mailing Address
First Line	:	805 N GRAHAM AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5435 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6411
Country	:	US
Telephone Number	:	317-226-4257
Fax Number	:

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

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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Directions to “ HAILLEY PEARL BOUWERS ” Practice Location

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