Nicole Patrice Vine-Braun
Individual provider Active NPI Gerontology Occupational Therapist · New Carlisle, IN
NPI 1831978030 · NPPES record last updated Sep 26, 2023
Key facts
- NPI
- 1831978030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Occupational Therapist 225XG0600X
- License
- 31003762A (IN)
- Practice address
- 31869 Chicago TRL
New Carlisle, IN 46552-9639 - Phone
- (574) 654-2266
- NPI assigned
- Sep 26, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003762A | IN | MD | Gerontology Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | 31003762A | IN | |
| Environmental Modification Occupational Therapist | 225XE0001X | 31003762A | IN | |
| Gerontology Occupational Therapist | 225XG0600X | 31003762A | IN | Yes |
Addresses
Primary practice location
31869 Chicago TRL
New Carlisle, IN 46552-9639
Mailing address
33927 Prairie Edge Dr
New Carlisle, IN 46552-8253
Phone (317) 408-2020
Other names
- Nicole Patrice Braun
Other providers in New Carlisle, IN
- Therapy and Learning Services Inc
- Katelyn Thompson
- Nicholas Michael Timm
- Town of New Carlisle
- Under One Umbrella LLC
- Kyndra Wagner
- Arianna Wallen
- Howard Wiesjahn
- Woodlawn Hospital
- Karen Lee Workinger
All providers in New Carlisle, IN · Gerontology Occupational Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.