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NPI Code Detail

MEDICARE: NICHOLE PRINCE

MEDICARE: NICHOLE PRINCE
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1194546929
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE PRINCE
Provider Business Mailing Address
First Line : 3650 S EASTERN AVE # 150C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3379
Country : US
Telephone Number : 702-401-4659
Fax Number : 702-268-7767
Provider Business Practice Location Address
First Line : 3650 S EASTERN AVE # 150C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3379
Country : US
Telephone Number : 702-401-4659
Fax Number : 702-268-7767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2024
Last Update Date : 10/23/2024

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Directions to “ NICHOLE PRINCE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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