| Nicole Ashley Wheeler, | |
| 
					610 N Michigan St Ste 400, South Bend, IN 46601-1081  | |
| (574) 647-8120 | |
| (574) 647-8111 | 
| Full Name | Nicole Ashley Wheeler | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 610 N Michigan St Ste 400, South Bend, Indiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346975356 | NPI | - | NPPES | 
| 300038057 | Medicaid | IN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71023836A (Indiana) | Secondary | 
| 363LA2200X | Nurse Practitioner - Adult Health | 71012836A (Indiana) | Primary | 
| Entity Name | Beacon Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657  | 
| Entity Name | Informe Healthcare Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1407343965 PECOS PAC ID: 8123375474 Enrollment ID: O20180723000258  | 
| Entity Name | Informe Healthcare In Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1992276638 PECOS PAC ID: 9537407770 Enrollment ID: O20190213000486  | 
| Entity Name | Informe Hc Specialists Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1255917647 PECOS PAC ID: 5698184885 Enrollment ID: O20210428002612  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Nicole Ashley Wheeler, 3245 Health Dr Ste 100, Granger, IN 46530-1380 Ph: () -  | Nicole Ashley Wheeler, 610 N Michigan St Ste 400, South Bend, IN 46601-1081 Ph: (574) 647-8120  | 
Beth Ann Hayden, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 707 N Michigan St, Ste 400, South Bend, IN 46601 Phone: 574-647-8470 Fax: 574-647-8475  | |
Rachel Ann Jennings, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000  | |
Kelly Mae Losiniecki, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 211 N Eddy St., South Bend, IN 46617 Phone: 574-237-9231 Fax: 574-204-6355  | |
Mrs. Brandice Lynn Page, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 53760 Generations Dr, South Bend, IN 46635 Phone: 888-938-3838 Fax: 888-919-1083  | |
Gina M. Connolly, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Navarre Pl Ste 6600, South Bend, IN 46601 Phone: 574-647-8800 Fax: 574-647-8896  | |
Amanda Lundberg, MSN, RN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 53830 Generations Dr Ste 110, South Bend, IN 46635 Phone: 574-234-2191  | |
Kendall Hochstedler,  Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1960 Northside Blvd, South Bend, IN 46615 Phone: 574-307-7673 Fax: 574-234-4706  |