Individual
NICOLE JOY MINNICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6913 N MAIN ST, GRANGER, IN 46530-8039
(574) 647-1500
(574) 243-4306
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004130A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300081384
—
IN
Enumeration date
01/12/2023
Last updated
01/05/2026
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