| Nicole Leigh Fornalik, PA-C | |
|
5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 | |
| (574) 237-1328 | |
| (574) 237-1348 |
| Full Name | Nicole Leigh Fornalik |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 21 Years |
| Location | 5340 Holy Cross Pkwy, Mishawaka, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982635587 | NPI | - | NPPES |
| 300007442 | Medicaid | IN |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lutheran Hospital Of Indiana | Fort wayne, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lutheran Medical Group Llc | 4981751617 | 261 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Leigh Fornalik, PA-C 100 E Wayne St Ste 510, South Bend, IN 46601-2394 Ph: (574) 334-5400 | Nicole Leigh Fornalik, PA-C 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 Ph: (574) 237-1328 |
Collins Abere, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Duane M Wampler, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1802 Day Rd, Mishawaka, IN 46545 Phone: 574-204-7200 Fax: 574-252-0633 | |
Mrs. Diana E Perez - Solano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 611 E Douglas Rd Ste 207, Mishawaka, IN 46545 Phone: 574-335-6850 Fax: 574-335-0849 | |
Emily Elston, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 505 W Cleveland Rd, Mishawaka, IN 46545 Phone: 574-235-3135 | |
David Eugene Fellows, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Emily Grace Gouker, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 270 E Day Rd Ste 280, Mishawaka, IN 46545 Phone: 574-271-0268 Fax: 574-271-0395 | |
Mr. Tyler Stephen Clutter, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-523-3160 Fax: 574-523-3221 |