MEDICARE: MIA NISLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	041510100	IL
2	163W00000X	Registered Nurse	RN9557804	FL

General Provider Information

NPI Number	:	1356277040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIA NISLE

Provider Business Mailing Address
First Line	:	7241 E 104TH PL
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307-7685
Country	:	US
Telephone Number	:	219-444-5225
Fax Number	:

Provider Business Practice Location Address
First Line	:	10865 MAPLE LN STE B
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8660
Country	:	US
Telephone Number	:	219-365-8546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2026
Last Update Date	:	06/20/2026

Similar Medicare Providers

1952509143 — CHIROPRACTIC CONNECTION PC
Practice Location Address:

709 COUNTY ROAD 75 W
SAINT JOSEPH, MN
56374-8660

Practice Phone: 320-363-4694
Practice Fax: 320-363-4643

1639447535 — MICHELLE CROCKER ATC
Practice Location Address:

1 COLLEGE PARK DR
SAINT LOUIS, MO
63141-8660

Practice Phone: 314-485-8415
Practice Fax:

1316289283 — WAL-MART STORES EAST LP
Practice Location Address:

10550 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL
32257-8660

Practice Phone: 904-380-8274
Practice Fax: 904-380-8275

1144562232 — DR. AMY KRISTEN SOK PHARMD
Practice Location Address:

10550 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL
32257-8660

Practice Phone: 904-380-8274
Practice Fax:

1982024345 — MR. CRAIG ZURLIENE MHA, ATC
Practice Location Address:

1 COLLEGE PARK DR
SAINT LOUIS, MO
63141-8660

Practice Phone: 314-392-2399
Practice Fax:

1811306459 — BRIANNA NELSON ATC
Practice Location Address:

1 COLLEGE PARK DR
SAINT LOUIS, MO
63141-8660

Practice Phone: 314-485-8415
Practice Fax:

Directions to “ MIA NISLE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.