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Individual

MS. DENISE HELEN LICINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6827 W TROPICANA AVE STE 110, LAS VEGAS, NV 89103-4920
(702) 508-9128
(702) 302-4125
Mailing address
705 GRANITE RAPIDS ST, LAS VEGAS, NV 89138-7529
(862) 228-0578

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN822758
NV
363L00000X
Nurse Practitioner
NPF21784
CA
363LA2200X
Adult Health Nurse Practitioner
NC085069
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21784
NP
CA
01
818601
RN
CA
01
HD702Z
MEDICARE PTAN
CA
Enumeration date
05/03/2006
Last updated
12/09/2022
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