MEDICARE: MRS. AMINA RACHEL LOUCAS ARNP, FNP-BC

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	9288080	FL

General Provider Information

NPI Number	:	1407248461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMINA RACHEL LOUCAS ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	2226 HUALAPAI MOUNTAIN RD
Second Line	:	STE 101
City	:	KINGMAN
State	:	AZ
Zip	:	86401-8374
Country	:	US
Telephone Number	:	305-807-1591
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 NE 170TH ST
Second Line	:	APT 105
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3138
Country	:	US
Telephone Number	:	305-807-1591
Fax Number	:

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

Provider Enumeration Date	:	02/28/2015
Last Update Date	:	07/08/2019

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