Individual provider · Type 1 NPI

Nicole Leigh Fornalik, PA-C

Physician Assistant · Indianapolis, IN

NPI number 1982635587 Active

Practice location

8040 Clearvista Pkwy Ste 490
Indianapolis, IN 46256-5604

Call (317) 621-5450 Map

Fax (317) 621-5453

Mailing address

6626 E 75th St Ste 500
Indianapolis, IN 46250-2890

Other practice locations

  • 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 · (574) 237-1328

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X10000784A (IN)
Medical Physician Assistant 363AM0700X10000784A (IN)
Physician Assistant Primary 363A00000X10000784A (IN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1982635587

Nicole Leigh Fornalik, PA-C's National Provider Identifier is 1982635587, issued on Jul 5, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Indianapolis, IN. The record was last updated on Jul 15, 2025.