Provider Demographics
NPI:1548664980
Name:VALENCIA, NICOLE (CRNA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 GEMINI ST
Mailing Address - Street 2:SUITE 128
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2746
Mailing Address - Country:US
Mailing Address - Phone:281-218-9515
Mailing Address - Fax:281-218-9534
Practice Address - Street 1:1002 GEMINI ST
Practice Address - Street 2:SUITE 128
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2746
Practice Address - Country:US
Practice Address - Phone:281-218-9515
Practice Address - Fax:281-218-9534
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0000605-C-CRNA367500000X
TX865653367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered