Provider Demographics
NPI:1376221135
Name:NISTOR, NICOLETA ALEXANDRA (NP)
Entity Type:Individual
Prefix:
First Name:NICOLETA
Middle Name:ALEXANDRA
Last Name:NISTOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16814 ALLEMAND LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3798
Mailing Address - Country:US
Mailing Address - Phone:281-707-6868
Mailing Address - Fax:
Practice Address - Street 1:16814 ALLEMAND LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3798
Practice Address - Country:US
Practice Address - Phone:281-707-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128002363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health