MRS. CHANDA LEA NICOSIA (NPI# 1316114655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316114655 |
| Entity Type | Individual |
| Full Name | MRS. CHANDA LEA NICOSIA |
| Credential | CSFA/LSA |
| Practice Address |
13674 Arizona Dr Tyler TX 75707-6806 |
| Practice Telephone | 9032163561 |
| Practice Fax Number | 9035666816 |
| Mailing Telephone | 9032163561 |
| Mailing Fax Number | 9035666816 |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2015-11-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
SA00471 | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
13674 ARIZONA DR |
| City | TYLER |
| State | TX |
| Zip Code | 75707-6806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821419011 | Nicosia Enterprises LLC | Specialist/Technologist, Other | 13674 Arizona Dr, Tyler, TX 75707-6806 | 2013-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063916351 | Veronica Miller | Registered Nurse | 3928 Mobley Lane, Tyler, TX 75707 | 2018-03-21 |
| 1023548187 | Juan Fernando Melgoza Jr. | Specialist/Technologist | 13172 Tx-64, Tyler, TX 75707 | 2017-06-12 |
| 1396291969 | The Center At Grande, LLC | Skilled Nursing Facility | 3219 East Grande Blvd, Tyler, TX 75707 | 2016-09-01 |
| 1730432493 | Michelle Tucker | Clinic/Center | 5011 Troup Hwy Ste 100, Tyler, TX 75707 | 2012-10-18 |
| 1275724569 | Johnson Chiropractic Center | Chiropractor | 5400 University Blvd, 103, Tyler, TN 75707 | 2007-08-05 |
| 1104851096 | Raymond F Jordan | Family Medicine | 12295 Hwy. 64 E, Tyler, TX 75707 | 2006-07-11 |
| 1033514096 | David Comins Wheeler | Counselor | 5875 Grace Ave, Tyler, TX 75707-0006 | 2014-11-01 |
| 1497318968 | Haley Lynn Dominy | Licensed Vocational Nurse | 6028 Grace Ave, Tyler, TX 75707-0007 | 2019-04-19 |
| 1710947957 | Doug Hodde | Family Medicine | 3593 E Grande Blvd, Tyler, TX 75707-1400 | 2006-03-23 |
| 1851839120 | Trinity Clinic | Clinic/Center | 3593 E Grande Blvd, Tyler, TX 75707-1400 | 2017-02-07 |
| Find all providers in zip 75707 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770571093 | Paul Blake Chlapek | Physician Assistant | 1905 S Donnybrook Ave, Tyler, TX 75701-4236 | 2005-10-11 |
| 1912526153 | Iana G Harris | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-04-08 |
| 1568009058 | East Texas First Surgical Support Pllc | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-12-04 |
| 1740840651 | Samantha Anderson Ray | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-13 |
| 1326540097 | Jennifer Marie Mckelva | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2018-03-08 |
| 1649309410 | Jonathan R Redwing | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2007-03-05 |
| 1972534683 | Marvin Dean Pennington | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2006-07-05 |
| 1568418242 | Michael A Sullivan | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2006-05-25 |
| 1639167703 | Robert Daniel Walker | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2005-10-12 |
| 1851389175 | Forrest Rice Persing | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2005-10-11 |
| Find all providers in TYLER | ||||
Please comment or provide details below to improve the information on MRS. CHANDA LEA NICOSIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.