Individual
NICOLE L ATACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3801 N LAMAR BLVD, AUSTIN, TX 78756-4080
(512) 558-1443
(830) 885-2670
Mailing address
PO BOX 300087, AUSTIN, TX 78703-0002
(512) 558-1443
(830) 885-2670
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
729081
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP123157
TX
Other
Enumeration date
03/14/2013
Last updated
08/12/2024
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