Provider Demographics
NPI:1558452540
Name:PRESCOTT, KIA NICOLE (ARNP)
Entity type:Individual
Prefix:
First Name:KIA
Middle Name:NICOLE
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NW 170TH ST STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5511
Mailing Address - Country:US
Mailing Address - Phone:305-653-4105
Mailing Address - Fax:305-652-3566
Practice Address - Street 1:100 NW 170TH ST STE 304
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5511
Practice Address - Country:US
Practice Address - Phone:053-653-4105
Practice Address - Fax:305-652-3566
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3097822363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306401800Medicaid
FLAJ262XMedicare PIN