NPI age
19 years
Enumerated 2007-08-20
● Active
Type 1 · Individual
Mimi Song Idicula, NP
Idicula is 1 of 39 nurse practitioner providers in Irving and 1 of 5,397 in Texas.
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-07-13
Source: CMS NPPES provider record
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5397 active nurse practitioner providers in Texas.
NPI age
19 years
↑ 11 yr above median (8 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
1
In the 36% of peers with subspecialties
NPI lifetime · 2007 → 2021
2007-08Enumerated in NPPES
2007
2021
Where they practice
Practice location
6161 N State Highway 161
Irving, TX 750382220
Mailing address
6161 N State Highway 161
Irving, TX 750382220
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1717 W University Dr, #408
McKinney, TX 75069
Specialties
-
Nurse Practitioner Primary(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...
-
ChiropractorA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | AP137449 | NURSE PRACTITIONER |
Practice context
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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