Nicole Anne Waletzki

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT8152 Issued in TX

Practice address

2900 S Valley Pkwy
Lewisville, TX 75067-2077

Phone

(972) 829-2111

NPI assigned

Sep 20, 2022

Last updated

Sep 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1891418364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 STUNNING DR",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750684004",
            "telephone_number": "571-225-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S VALLEY PKWY",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750672077",
            "telephone_number": "972-829-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALETZKI",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas LLC (Walmart Pharmacy 100217)
• Wal-Mart Stores Texas LP (Wal-Mart Vision Center 30-5092)
• Wal-Mart Stores Texas, LP (Vision Center 30-0426)
• Wal-Mart Stores Texas, LP (Vision Center 30-0217)
• Mark B Waldman, MD
• Walgreen Co (Walgreens #05960)
• Aisha Zeenat Walker, PHARMD
• Carma Walker, M.ED., LPC
• Isabella Walker
• Jamie Walker, LPC

• Athletic Trainer in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.