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General NPI Number Information
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NPI Number | 1407248461
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Entity Type | Individual
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Provider Name | AMINA RACHEL LOUCAS ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2015
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 4000 NE 170TH ST APT 105
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33160-3138
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Country | US
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Telephone | 305-807-1591
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Fax |
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Provider Business Mailing Address
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Address Line | 2226 HUALAPAI MOUNTAIN RD STE 101
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City | KINGMAN
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State | AZ
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Zip | 86401-8374
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Country | US
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Telephone | 305-807-1591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9288080
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License Number State | FL
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