Healthcare Provider Details

I. General information

NPI: 1073539268
Provider Name (Legal Business Name): SHIRLEE CICALE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FRANKLIN BLVD
LEMOORE CA
93246-4700
US

IV. Provider business mailing address

937 FRANKLIN AVENUE: FPC NH LEMOORE
LEMOORE CA
93245-0000
US

V. Phone/Fax

Practice location:
  • Phone: 559-998-4262
  • Fax: 559-998-2815
Mailing address:
  • Phone: 559-998-2749
  • Fax: 559-998-2815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number272154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: