Provider Demographics
NPI:1437229234
Name:LEA, NICOLE C (CPNP)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:C
Last Name:LEA
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6701 FANNIN ST
Mailing Address - Street 2:SUITE 1040
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2608
Mailing Address - Country:US
Mailing Address - Phone:832-822-3308
Mailing Address - Fax:832-825-3308
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:SUITE 1040
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2608
Practice Address - Country:US
Practice Address - Phone:832-822-3308
Practice Address - Fax:832-825-3308
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX671248363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ69346Medicare UPIN