Powell, Nicole Marie

Powell, Nicole Marie is an individual health care provider with primary practice located at 3600 W Bethel Ave , Muncie IN 47304-5407. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Powell, Nicole Marie can be contacted via phone (765) 213-3870.

Contact Information

Primary practice address
3600 W Bethel Ave Muncie IN 47304-5407
Phone: (765) 213-3870
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 05010696A Indiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 99048667A Indiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05010696A Indiana

Profile Details

NPI number 1053697862
LBN Legal business name Powell, Nicole Marie
Credentials DPT, ATC, LAT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2011
Last updated Apr 18th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053697862 NPPES
Indiana Other 1103842746 ANTHEM PTAN
Indiana MEDICAID 300088469 ANTHEM PTAN

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