Nicole Wallis
Nicole Wallis is an Occupational Therapist in Private Practice in Greenwood, Indiana. Qualified in 2020, 6 years ago. Practices with Chn Jmh Ventures LLC, a 20-clinician group and accepts Medicare assignment.
- Years since qualifying
- 6
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
3000 N State Rd 135Greenwood, IN 46143
Phone: (800) 777-7775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Occupational Therapist (primary) | Taxonomy 225X00000X |
|---|---|
| Neurorehabilitation Occupational Therapist | Taxonomy 225XN1300X |
Record details
| NPI number | 1629739206 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | January 5, 2022 |
| Last updated in NPPES | January 5, 2022 |
| Certification date | January 4, 2022 |
| Mailing address | 910 N Dequincy St, Indianapolis, IN 46201-2844 |
Medicare enrollment
| Medicare specialty | OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Group practice | Chn Jmh Ventures Llc — 20 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |