Provider Demographics
NPI:1588311724
Name:NICOLAS, MARIE (CLD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:NICOLAS
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5448
Mailing Address - Country:US
Mailing Address - Phone:832-520-5621
Mailing Address - Fax:
Practice Address - Street 1:4615 MAGNOLIA LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5448
Practice Address - Country:US
Practice Address - Phone:832-520-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty