Provider Demographics
NPI:1770793168
Name:NICHTBERGER, TERESA DOBREC (RN, MSN, C-FNP)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DOBREC
Last Name:NICHTBERGER
Suffix:
Gender:F
Credentials:RN, MSN, C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MEDICAL CENTER BLVD. SUITE 2100
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-332-0073
Mailing Address - Fax:281-332-1860
Practice Address - Street 1:450 MEDICAL CENTER BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4229
Practice Address - Country:US
Practice Address - Phone:281-332-0073
Practice Address - Fax:281-332-1860
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX508892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily