Provider Demographics
NPI:1770505901
Name:DAMON, NOLA SIKORA (RN, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:NOLA
Middle Name:SIKORA
Last Name:DAMON
Suffix:
Gender:F
Credentials:RN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 E GRANT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-3208
Mailing Address - Country:US
Mailing Address - Phone:432-580-3700
Mailing Address - Fax:432-580-3707
Practice Address - Street 1:3409 ANDREWS HWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5149
Practice Address - Country:US
Practice Address - Phone:432-580-3700
Practice Address - Fax:432-580-3707
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251442363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186022302Medicaid
TX186022302Medicaid