MEDICARE: APRIL JOY KICE FNP

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
1	363LF0000X	Family Nurse Practitioner	TAPN700860	NV
2	363LF0000X	Family Nurse Practitioner	APRN001515	NV

General Provider Information

NPI Number	:	1881934602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL JOY KICE FNP

Provider Business Mailing Address
First Line	:	12900 PARK PLAZA DR STE 150
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-9329
Country	:	US
Telephone Number	:	562-977-4639
Fax Number	:	562-741-4479

Provider Business Practice Location Address
First Line	:	3401 E. FLAMINGO
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121
Country	:	US
Telephone Number	:	937-239-7879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	04/06/2024

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