Kyle Douglas Hicks

NPI 1700647542ActiveIndividual· Nurse Practitioner, Family· Fresno, CA

Nurse Practitioner, Family with Northeastern Anesthesia PLLC, practicing in Fresno, California. Enrolled in Medicare as practitioner - certified registered nurse anesthetist (crna) and practitioner - certified registered nurse anesthetist (crna). Lists Havasu Regional Medical Center and 3 other hospitals as hospital affiliations.

Overview

NPI	1700647542
Status	Active
Entity type	Individual
Sole proprietor	Yes
NPI issued	Jan 18, 2024
Last updated in NPPES	Jan 18, 2024
Certified by provider	Jan 11, 2024

Specialties and licenses

Taxonomy	Code	License	State
Nurse Practitioner, Family Primary	363LF0000X	95022187	CA
Registered Nurse, Critical Care Medicine	163WC0200X	95069170	CA
Nurse Anesthetist, Certified Registered	367500000X	95069170	CA

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Nov 10, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026	No match	—
New York OMIG · Nov 11, 2026	No match	—
Ohio Medicaid · Nov 11, 2026	No match	—
Pennsylvania Medicheck · Nov 11, 2026	No match	—
Washington HCA · Nov 11, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (AZ); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (CA)

Medicare sources and data years