MEDICARE: DEWANN SQUIRES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1598568560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEWANN SQUIRES

Provider Business Mailing Address
First Line	:	9105 E 56TH ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46216-2231
Country	:	US
Telephone Number	:	463-710-1439
Fax Number	:

Provider Business Practice Location Address
First Line	:	9105 E 56TH ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46216-2231
Country	:	US
Telephone Number	:	463-710-1439
Fax Number	:

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

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/31/2025

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Directions to “ DEWANN SQUIRES ” Practice Location

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