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NPI Code Detail

MEDICARE: LORI KUNICKI A.A.S BC-HIS

MEDICARE: LORI KUNICKI A.A.S BC-HIS
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
1237700000XHearing Instrument Specialist387NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1387OTHERNVHEARING AID SPECIALIST LICENSE

General Provider Information

NPI Number : 1184097404
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI KUNICKI A.A.S BC-HIS
Provider Business Mailing Address
First Line : 5710 SIMMONS ST STE 120
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-7281
Country : US
Telephone Number : 702-990-9409
Fax Number :
Provider Business Practice Location Address
First Line : 5710 SIMMONS ST STE 120
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-7281
Country : US
Telephone Number : 702-990-9409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2015
Last Update Date : 11/09/2015

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