Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 801266 | TX |
NPI | 1528533981 |
---|---|
Provider Name | Nicole Iginiamre |
First Address | Houston, TX 77030-2604 |
Second Address | Houston, TX 77030-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2018 |
Last Update Date | 11/10/2018 |