Provider Demographics
NPI:1255788378
Name:ALEGRIA, NICHOLE (DNP, ENP-C, FNP-C)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:ALEGRIA
Suffix:
Gender:F
Credentials:DNP, ENP-C, FNP-C
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:GAMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 W LAMPASAS ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-5644
Mailing Address - Country:US
Mailing Address - Phone:469-256-2155
Mailing Address - Fax:
Practice Address - Street 1:375 FM 548 STE 100
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-6985
Practice Address - Country:US
Practice Address - Phone:972-564-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX776897163WE0003X
TXAP131231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency