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Individual

MRS. SHIRLEY A MALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3468 STELLHORN RD, FORT WAYNE, IN 46815-4630
(260) 755-6589
(260) 444-4969
Mailing address
3468 STELLHORN RD, FORT WAYNE, IN 46815-4630
(260) 755-6589
(260) 444-4969

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
18-014453-1
IN
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300017609
IN
Enumeration date
10/16/2018
Last updated
10/10/2024
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