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General NPI Number Information
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NPI Number | 1326810698
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Entity Type | Individual
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Provider Name | NICOLE MARIE EHLERT PNP-PC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 3611 S REED RD STE 108
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City | KOKOMO
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State | IN
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Zip | 46902-3828
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Country | US
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Telephone | 765-776-3700
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Fax | 765-450-1288
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71015884A
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License Number State | IN
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