Provider Demographics
NPI:1437554607
Name:NORMAN, NICOLE LEIGH (AGPCNP-BC, NP-C, RN)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:LEIGH
Last Name:NORMAN
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Gender:F
Credentials:AGPCNP-BC, NP-C, RN
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Mailing Address - Street 1:7000 N MO PAC EXPY
Mailing Address - Street 2:STE 420
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3055
Mailing Address - Country:US
Mailing Address - Phone:512-482-0045
Mailing Address - Fax:512-476-9892
Practice Address - Street 1:7000 N MO PAC EXPY
Practice Address - Street 2:STE 420
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3055
Practice Address - Country:US
Practice Address - Phone:512-482-0045
Practice Address - Fax:512-476-9892
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2016-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP125539363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX393995YM8AMedicare PIN