National Provider Identifier

Alyse Renee Kickbush, LPN

Alyse Renee Kickbush, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Conewango Valley, NY and a listed phone number of (716) 352-1593.

NPI 1427424662Conewango Valley, NYLicensed Practical Nurse

Profile Overview

NPI
1427424662
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
August 11, 2015
Last Updated
August 11, 2015

Practice Location

  • 5165 Route 62
  • Conewango Valley, NY 14726-9713

Phone: (716) 352-1593

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1427424662
Entity Type
Individual
Last Name
Kickbush
First Name
Alyse
Middle Name
Renee
Name Prefix
Miss
Credential
LPN
Mailing Street Address
5165 Route 62
Mailing City
Conewango Valley
Mailing State
NY
Mailing ZIP Code
14726-9713
Mailing Country
US
Mailing Phone
(716) 352-1593
Practice Street Address
5165 Route 62
Practice City
Conewango Valley
Practice State
NY
Practice ZIP Code
14726-9713
Practice Country
US
Practice Phone
(716) 352-1593
Enumeration Date
August 11, 2015
Last Updated
August 11, 2015
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)