Individual
NICOLE ASHLEY WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 N MICHIGAN ST STE 400, SOUTH BEND, IN 46601-1081
(574) 647-8120
(574) 647-8111
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71023836A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71012836A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300038057
—
IN
Enumeration date
07/22/2022
Last updated
01/22/2025
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