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Mimi Song Idicula, NP
Nurse Practitioner in Irving, Texas
NPI 1003009580

Mimi Song Idicula is a Nurse Practitioner based in Irving, TX. Mimi Song Idicula practices in Irving, TX and has the professional credentials of NP. The NPI Number for Mimi Song Idicula is 1003009580 and holds a License No. 10049 (Texas).

The current practice location address for Mimi Song Idicula is 6161 N State Highway 161, Irving, TX and can be reached out via phone at 972-258-7499 and via fax at 972-257-0897.

Location: 6161 N State Highway 161, Irving, TX, 75038-2220
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003009580
Provider Name
Mimi Song Idicula
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
6161 N State Highway 161, Irving, TX, 75038-2220
Phone Number
972-258-7499
Fax Number
972-257-0897
Provider Enumeration Date
08/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP137449 01 TX NURSE PRACTITIONER
institution
Provider Business Practice Location Address Details
Address
6161 N State Highway 161
City
Irving
State
Texas
Zip
75038-2220
Phone Number
972-258-7499
Fax Number
972-257-0897
person
Provider Business Mailing Address Details
Address
6161 N State Highway 161
City
Irving
State
Texas
Zip
75038-2220
Phone Number
972-258-7499
Fax Number
972-257-0897
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
AP137449 (Texas)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
10049 (Texas)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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