Individual
NICOLE L HECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
201 W ACADEMY ST, BLOOMINGDALE, IN 47832-8095
(765) 498-9000
(765) 498-9004
Mailing address
201 W ACADEMY ST, BLOOMINGDALE, IN 47832-8095
(765) 498-9000
(765) 498-9004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001576A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000837406
ANTHEM
IN
Enumeration date
09/25/2013
Last updated
06/23/2021
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