Healthcare Provider Details

I. General information

NPI: 1235666884
Provider Name (Legal Business Name): ASHLEY J DYKES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 OSIGIAN BLVD STE 4
WARNER ROBINS GA
31088-8985
US

IV. Provider business mailing address

3448 VINEVILLE AVE
MACON GA
31204-1867
US

V. Phone/Fax

Practice location:
  • Phone: 478-405-0045
  • Fax: 478-405-0054
Mailing address:
  • Phone: 478-405-0045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN215843
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: