Individual provider Active NPI

Nicole Lee Kroll, FNP-BC, PMHNP-BC

  • Adult Health Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1508877267
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP115032 Issued in TX
Practice address
8447 John Sharp Pkwy
Bryan, TX 77807-1552
Phone
(979) 436-0291
Fax
(979) 436-0102
NPI assigned
Aug 10, 2006
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP115032 TX Primary
Family Nurse Practitioner 363LF0000X AP115032 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP115032 TX

Addresses

Primary practice location

8447 John Sharp Pkwy
Bryan, TX 77807-1552

Mailing address

8447 John Sharp Pkwy
Bryan, TX 77807-1552
Phone (361) 579-0315

Other practice location 1

311 Houston St
1264 Tamu
College Station, TX 77843-1264
Phone (979) 458-8300

Other names 1

  • Nicole Lee Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000717 TX Practitioner - Nurse Practitioner 5092713388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP115032TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center Family CurrentSince May 4, 2025 Accepting new patients
Texas a&M University EMS CurrentSince Oct 30, 2022 Accepting new patients
Texas a & M University Current Accepting new patients
Regional Employee Assistance Program Inc Past Accepting new patients
Christopher R Lockhart MD, PA Past Accepting new patients
St. Joseph Regional Health Center Past Accepting new patients
Vanguard Geriatrics Inc Adult Health Past Accepting new patients
Aguirre Family Care Clinic Past Accepting new patients

Locations

8447 John Sharp Pkwy
Bryan, TX 77807
Phone (979) 436-0155

311 Houston St
College Station, TX 77843
Phone (979) 458-8300

Interoperability endpoints

  • Direct secure messaging: nkroll32318@texasamuniversity.gardenplot.direct-ci.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1508877267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8447 JOHN SHARP PKWY",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778071552",
            "telephone_number": "361-579-0315",
            "fax_number": "361-579-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8447 JOHN SHARP PKWY",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778071552",
            "telephone_number": "979-436-0291",
            "fax_number": "979-436-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Houston St",
            "address_2": "1264 Tamu",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778431264",
            "country_code": "US",
            "telephone_number": "979-458-8300",
            "fax_number": "979-459-8319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROLL",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP115032",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP115032",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP115032",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MOORE",
            "middle_name": "LEE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.