Brunette, Nicole S

Brunette, Nicole S is an individual health care provider with primary practice located at 600 East Blvd Emergency Department, Elkhart IN 46514-2483. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Brunette, Nicole S can be contacted via phone (574) 523-3161.

Contact Information

Primary practice address
600 East Blvd Emergency Department Elkhart IN 46514-2483
Phone: (574) 523-3161
Fax: (574) 273-1137
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01050872 Indiana

Profile Details

NPI number 1003816059
LBN Legal business name Brunette, Nicole S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Dec 20th, 2011 - about 13 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 1003816059 NPPES
Michigan MEDICAID 104280367
Michigan MEDICAID 2003188880
Michigan Other 930102252
Michigan Other 000000190010

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