Provider Demographics
NPI:1164132254
Name:NELSON, NICOLE M (APN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:M
Last Name:NELSON
Suffix:
Gender:F
Credentials:APN, PMHNP-BC
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:MURMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARRIED 10/15/22
Mailing Address - Street 1:5424 W HIGHWAY 290 STE 108
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8842
Mailing Address - Country:US
Mailing Address - Phone:512-430-1130
Mailing Address - Fax:512-677-6806
Practice Address - Street 1:5424 W HIGHWAY 290 STE 108
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8842
Practice Address - Country:US
Practice Address - Phone:512-430-1130
Practice Address - Fax:512-677-6806
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1005118163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse