MEDICARE: NICOLE KILBURN

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1982534822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE KILBURN

Provider Business Mailing Address
First Line	:	2900 PALOMINO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-4506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 PALOMINO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-4506
Country	:	US
Telephone Number	:	725-777-1373
Fax Number	:

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

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ NICOLE KILBURN ” Practice Location

Language	Start Address	Practice Location

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