Provider Demographics
NPI:1154216687
Name:ALEBESUN, NICOLE EFE (CAA)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:EFE
Last Name:ALEBESUN
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S CONGRESS AVE APT 1114
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2454
Mailing Address - Country:US
Mailing Address - Phone:713-505-5821
Mailing Address - Fax:
Practice Address - Street 1:5656 BEE CAVES RD
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5280
Practice Address - Country:US
Practice Address - Phone:512-327-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78970561367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered