Provider Demographics
NPI:1487823175
Name:KIMBLE, ERIKA NICOLE (RN, BSN, MA, MS, NP)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:NICOLE
Last Name:KIMBLE
Suffix:
Gender:F
Credentials:RN, BSN, MA, MS, NP
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:NICOLE
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11035 LAVENDER HILL DR STE 160-326
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2955
Mailing Address - Country:US
Mailing Address - Phone:702-670-2048
Mailing Address - Fax:
Practice Address - Street 1:2800 N TENAYA WAY STE 203
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1100
Practice Address - Country:US
Practice Address - Phone:702-202-2700
Practice Address - Fax:702-307-5480
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH09894OtherARNP
OH09894OtherARNP