Provider Demographics
NPI:1942832191
Name:MORCILLA, JOEL NIEVES (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:NIEVES
Last Name:MORCILLA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10511 SHANLEY TRACE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2725
Mailing Address - Country:US
Mailing Address - Phone:713-518-3236
Mailing Address - Fax:
Practice Address - Street 1:1113 W BAKER RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2391
Practice Address - Country:US
Practice Address - Phone:281-838-8412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX861301163WE0003X
TXAP145635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency