Individual
NICHOLLE M HISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1060 S MAIN ST, SUITE 3, TIPTON, IN 46072-8327
(765) 675-7009
(765) 675-3914
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006134A
IN
363LF0000X
Family Nurse Practitioner
71006134A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201354720
—
IN
Enumeration date
04/08/2016
Last updated
05/24/2025
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