MEDICARE: KUMIKO NAKAMURA APRN

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
1	363LF0000X	Family Nurse Practitioner	3003750	KY
2	363LF0000X	Family Nurse Practitioner	COA 10689-NP	OH

General Provider Information

NPI Number	:	1235115536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUMIKO NAKAMURA APRN

Provider Business Mailing Address
First Line	:	2840 ALEXANDRIA PIKE
Second Line	:
City	:	HIGHLAND HEIGHTS
State	:	KY
Zip	:	41076-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 ALEXANDRIA PIKE
Second Line	:
City	:	HIGHLAND HEIGHTS
State	:	KY
Zip	:	41076-1523
Country	:	US
Telephone Number	:	859-814-0307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	12/20/2013

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