Individual
NYCOLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601-1033
(574) 647-3281
(574) 647-1094
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01069789A
IN
208M00000X
Hospitalist Physician
01069789A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000723191
BCBS MEMORIAL HOSPITALIST
IN
05
—
201034060
—
IN
01
—
M400055270
MEDICARE PTAN
IN
01
—
P01054050
RR MEDICARE
IN
Enumeration date
07/16/2008
Last updated
03/30/2026
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