Provider Demographics
NPI:1508612029
Name:ISMAIL, NAZISH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NAZISH
Middle Name:
Last Name:ISMAIL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4822 CRYSTAL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7185
Mailing Address - Country:US
Mailing Address - Phone:979-255-2727
Mailing Address - Fax:
Practice Address - Street 1:4822 CRYSTAL RIDGE CT
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-7185
Practice Address - Country:US
Practice Address - Phone:979-255-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily