Provider Demographics
NPI:1508635400
Name:ABRAHAM, NIMMY (APRN CNP)
Entity Type:Individual
Prefix:
First Name:NIMMY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 LA CONCHA LN STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1809
Mailing Address - Country:US
Mailing Address - Phone:832-831-7800
Mailing Address - Fax:832-831-7801
Practice Address - Street 1:1313 LA CONCHA LN STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1809
Practice Address - Country:US
Practice Address - Phone:832-831-7800
Practice Address - Fax:832-831-7801
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139821363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner