MEDICARE: NICOLE EILEEN CASH FNP-C

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	APRN001828	NV

General Provider Information

NPI Number	:	1659774909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE EILEEN CASH FNP-C

Provider Business Mailing Address
First Line	:	732 FLOWING MEADOW DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2665
Country	:	US
Telephone Number	:	928-234-3404
Fax Number	:

Provider Business Practice Location Address
First Line	:	5653 S HIGHWAY 95 STE A
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426
Country	:	US
Telephone Number	:	928-768-2558
Fax Number	:	928-788-2039

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

Provider Enumeration Date	:	10/01/2014
Last Update Date	:	06/22/2018

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