Provider Demographics
NPI:1932967403
Name:WILLIAMS, CHUANTIAVA (CNM)
Entity Type:Individual
Prefix:
First Name:CHUANTIAVA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 WEDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-5535
Mailing Address - Country:US
Mailing Address - Phone:219-487-1572
Mailing Address - Fax:
Practice Address - Street 1:13420 N MERIDIAN ST STE 420
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1581
Practice Address - Country:US
Practice Address - Phone:317-582-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000450A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife