Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle Douglas Hicks

Individual provider Critical Care Medicine Registered Nurse · NPI 1700647542

Kyle Douglas Hicks is a Certified Registered Nurse Anesthetist (CRNA) in Fresno, California. Qualified in 2025, 1 year ago. Practices with Northeastern Anesthesia PLLC, a 83-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

20 E River Park Pl W
Fresno, CA 93720-1551
Phone: (559) 256-4950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95022187 (CA)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 95069170 (CA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 95069170 (CA)

Record details

NPI number1700647542
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 18, 2024
Last updated in NPPESJanuary 18, 2024
Certification dateJanuary 11, 2024
Mailing address3222 Everglade Ave # A, Clovis, CA 93619-9586

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Northeastern Anesthesia Pllc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fresno