Individual
NATHAN D. NICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6511 E STATE BLVD, FORT WAYNE, IN 46815-7026
(260) 425-2725
(260) 479-4604
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009821A
IN
Other
Enumeration date
03/10/2020
Last updated
10/15/2020
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