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General NPI Number Information
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NPI Number | 1851995054
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Entity Type | Individual
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Provider Name | NICOLE RENEE ESPURVOA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 11/28/2020
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 4751 HAMILTON WOLFE RD STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3458
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Country | US
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Telephone | 210-233-7126
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Fax |
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Provider Business Mailing Address
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Address Line | 21303 ENCINO CMNS APT 1305
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City | SAN ANTONIO
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State | TX
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Zip | 78259-2230
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Country | US
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Telephone | 210-519-1997
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 840114
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1028632
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License Number State | TX
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