Provider Demographics
NPI:1952810822
Name:KERBOW, NICOLE MICHELLE (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MICHELLE
Last Name:KERBOW
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:MICHELLE
Other - Last Name:KERBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NICOLE DAVILA
Mailing Address - Street 1:3111 PLEASANT COVE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3233
Mailing Address - Country:US
Mailing Address - Phone:361-443-8626
Mailing Address - Fax:
Practice Address - Street 1:3111 PLEASANT COVE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3233
Practice Address - Country:US
Practice Address - Phone:361-443-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743955163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant