Provider Demographics
NPI:1467966374
Name:HERRING, NINA GRENA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:GRENA
Last Name:HERRING
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 DAWN RISE CT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7013
Mailing Address - Country:US
Mailing Address - Phone:281-687-8612
Mailing Address - Fax:
Practice Address - Street 1:9675 EAGLE DR
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77523-5606
Practice Address - Country:US
Practice Address - Phone:832-930-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX644295363LF0000X
TXAP135902363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10627657OtherTEXAS DRIVER'S LICENSE