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NPI Code Detail

MEDICARE: MS. ERIKA NICOLE KIMBLE RN, BSN, MA, MS, NP

MEDICARE: MS. ERIKA NICOLE KIMBLE RN, BSN, MA, MS, NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN001610NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109894OTHEROHARNP

General Provider Information

NPI Number : 1487823175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIKA NICOLE KIMBLE RN, BSN, MA, MS, NP
Provider Business Mailing Address
First Line : 11035 LAVENDER HILL DR STE 160-326
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-2955
Country : US
Telephone Number : 702-670-2048
Fax Number :
Provider Business Practice Location Address
First Line : 2800 N TENAYA WAY STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1100
Country : US
Telephone Number : 702-202-2700
Fax Number : 702-307-5480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 05/01/2020

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