Provider Demographics
NPI:1023140712
Name:LEGER-NICHOLSON, PATRICE ANN (RNC WHCNP)
Entity type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:ANN
Last Name:LEGER-NICHOLSON
Suffix:
Gender:F
Credentials:RNC WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7708
Mailing Address - Country:US
Mailing Address - Phone:214-590-0423
Mailing Address - Fax:214-590-5563
Practice Address - Street 1:7424 GREENVILLE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4534
Practice Address - Country:US
Practice Address - Phone:214-363-2004
Practice Address - Fax:214-696-2091
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX543969363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149426201OtherTPI