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General NPI Number Information
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NPI Number | 1811788771
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Entity Type | Individual
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Provider Name | KAILEY JAYCKLINE HICKEY WHNP
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2612 YELM HWY SE
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City | OLYMPIA
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State | WA
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Zip | 98501-4826
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Country | US
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Telephone | 360-507-8146
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Fax | 360-839-2852
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Provider Business Mailing Address
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Address Line | 2612 YELM HWY SE
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City | OLYMPIA
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State | WA
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Zip | 98501-4826
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Country | US
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Telephone | 360-507-8146
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Fax | 360-839-2852
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP70043574
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License Number State | WA
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