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NPI Code Detail

MEDICARE: OLIVIA L VANNESS

MEDICARE:   OLIVIA L VANNESS
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
11041C0700XClinical Social Worker99134466AIN

General Provider Information

NPI Number : 1447100797
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA L VANNESS
Provider Business Mailing Address
First Line : 11181 RIDGEWATER CIR
Second Line :
City : FISHERS
State : IN
Zip : 46037-8778
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5638 PROFESSIONAL CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-5042
Country : US
Telephone Number : 888-714-1927
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “ OLIVIA L VANNESS ” Practice Location

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