Provider Demographics
NPI:1780956102
Name:GRATO, NICKOLE ELIZABETH (NP)
Entity type:Individual
Prefix:MS
First Name:NICKOLE
Middle Name:ELIZABETH
Last Name:GRATO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:SADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:672 MCKEE CT
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6783
Mailing Address - Country:US
Mailing Address - Phone:214-642-6624
Mailing Address - Fax:
Practice Address - Street 1:672 MCKEE CT
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75087-6783
Practice Address - Country:US
Practice Address - Phone:214-642-6624
Practice Address - Fax:469-338-5195
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily