Healthcare Provider Details

I. General information

NPI: 1780509323
Provider Name (Legal Business Name): NICOLE EMILY UCHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6418 E 900 S
LAFAYETTE IN
47909-9195
US

IV. Provider business mailing address

PO BOX 344
DAYTON IN
47941-0344
US

V. Phone/Fax

Practice location:
  • Phone: 765-523-2141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number46004899A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: