SearchIndianaPhysician Assistant

Nicole Fornalik, PA-C

NPI 1982635587 · on the registry since 2006

Practice

Address
8040 Clearvista Pkwy Ste 490
Indianapolis, IN 46256
Phone
(317) 621-5450
Fax
(317) 621-5453
Organisation at this address
Larry N Monn, Md Inc
James H Brillhart Md Pc
Indiana Spine Group, Pc
Jeffrey D. Wagner, Md, Pc
Urology Of Indiana, L.L.C.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
95

Additional practice sites

  • 5340 Holy Cross Pkwy, Mishawaka, IN

Registry record

Primary taxonomy
Physician Assistant
363A00000X
Also registered as
Surgical Physician Assistant
Medical Physician Assistant
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-07-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana