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General NPI Number Information
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NPI Number | 1043730971
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Entity Type | Individual
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Provider Name | CIERRA NICOLE THOMAS RN, MSN, AGNP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4545 FULLER DR STE 325
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City | IRVING
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State | TX
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Zip | 75038-6530
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Country | US
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Telephone | 972-870-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 7120 MCCART AVE
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City | FORT WORTH
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State | TX
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Zip | 76133-7298
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Country | US
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Telephone | 817-294-5624
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP134228
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License Number State | TX
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