Henline, Nicole

Henline, Nicole is an individual health care provider with primary practice located at 10443 Illinois Rd , Fort Wayne IN 46814-9181. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Henline, Nicole can be contacted via phone (260) 625-5005.

Contact Information

Primary practice address
10443 Illinois Rd Fort Wayne IN 46814-9181
Phone: (260) 625-5005
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 06002875A Indiana

Profile Details

NPI number 1811176563
LBN Legal business name Henline, Nicole
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2007
Last updated Oct 30th, 2007 - about 18 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 1811176563 NPPES
Indiana Other 06002875A LICENSE

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