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Individual

NICOLE KAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N

Contact information

Practice address
4002 W HORATIO ST, TAMPA, FL 33609-3939
(813) 453-2217
Mailing address
9624 W PARK DR, TAMPA, FL 33626
(215) 480-4143

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
RN9322789
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
222Q00000X
FL
Enumeration date
01/12/2017
Last updated
01/12/2017
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