Healthcare Provider Details

I. General information

NPI: 1558452540
Provider Name (Legal Business Name): KIA NICOLE PRESCOTT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NW 170TH ST STE 304
NORTH MIAMI BEACH FL
33169-5511
US

IV. Provider business mailing address

100 NW 170TH ST STE 304
NORTH MIAMI BEACH FL
33169-5511
US

V. Phone/Fax

Practice location:
  • Phone: 53-653-4105
  • Fax: 305-652-3566
Mailing address:
  • Phone: 305-653-4105
  • Fax: 305-652-3566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP 3097822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: