MEDICARE: MRS. NIKOLE MILKA BARACH RN

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	207RC0000X	Cardiovascular Disease Physician	041-302829	IL

General Provider Information

NPI Number	:	1770418667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NIKOLE MILKA BARACH RN

Provider Business Mailing Address
First Line	:	10863 WALNUT DR
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8301
Country	:	US
Telephone Number	:	219-406-7622
Fax Number	:

Provider Business Practice Location Address
First Line	:	10863 WALNUT DR
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8301
Country	:	US
Telephone Number	:	219-406-7622
Fax Number	:

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

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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