Individual
NICOLE KAY DETWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-6576
Mailing address
1414 N SHEPHERD DR APT 401, HOUSTON, TX 77008-4092
(724) 396-6066
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1096254
TX
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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