Provider Demographics
NPI:1205205150
Name:WILER, NIKOLINA (PA-C)
Entity Type:Individual
Prefix:
First Name:NIKOLINA
Middle Name:
Last Name:WILER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NIKOLINA
Other - Middle Name:
Other - Last Name:KISELINOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5664 W STREAM DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-7001
Mailing Address - Country:US
Mailing Address - Phone:317-378-0156
Mailing Address - Fax:
Practice Address - Street 1:441 N WABASH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952
Practice Address - Country:US
Practice Address - Phone:317-378-0156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant