Provider Demographics
NPI:1215083761
Name:SOARES, NELIA P (RN, CPNP-AC/PC)
Entity type:Individual
Prefix:
First Name:NELIA
Middle Name:P
Last Name:SOARES
Suffix:
Gender:F
Credentials:RN, CPNP-AC/PC
Other - Prefix:
Other - First Name:NELIA
Other - Middle Name:S
Other - Last Name:DOENGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CPNP-AC/PC
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2331
Practice Address - Fax:214-456-2897
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX585748363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188220104OtherCSHCN
TX8F10105OtherMEDICARE
TX188220103Medicaid