Provider Demographics
NPI:1700397726
Name:PRICE, NICOLE L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:L
Last Name:PRICE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:ANISE
Other - Last Name:LISBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4802 MARTIN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:334-444-9119
Mailing Address - Fax:
Practice Address - Street 1:550 WESTCOTT ST STE 520
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-9001
Practice Address - Country:US
Practice Address - Phone:713-864-6694
Practice Address - Fax:713-864-6698
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135529363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health