Individual
MS. NICOLE NICHELLE IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-5300
Mailing address
PO BOX 848491, DALLAS, TX 75284-8491
(254) 202-5300
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP130311
TX
Other
Enumeration date
03/08/2010
Last updated
11/16/2018
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