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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