MIRACLE MICHELLE NICKERSON NPI 1619625092

NPI Information

NPI: 1619625092
Provider Name: MIRACLE MICHELLE NICKERSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
10521 CORPORATE DR
STAFFORD, TX
ZIP 77477
Phone: (832) 560-8907
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Miracle Michelle Nickerson is a family nurse practitioner in Stafford, TX. Miracle Michelle Nickerson NPI is 1619625092. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10521 CORPORATE DR
STAFFORD, TX
ZIP 77477-003
Phone: (832) 560-8907

The enumeration date for this NPI number is 3/14/2022 and was last updated on 3/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		883244	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	1065199	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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