Individual
NICOLE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3606 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3052
(463) 724-3416
(574) 323-3718
Mailing address
729 S WELLINGTON ST, SOUTH BEND, IN 46619-2924
(574) 323-3718
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28223419A
IN
Other
Enumeration date
09/23/2024
Last updated
05/27/2025
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