Provider Demographics
NPI:1811788771
Name:HICKEY, KAILEY JAYCKLINE (WHNP)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:JAYCKLINE
Last Name:HICKEY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2612 YELM HWY SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4826
Mailing Address - Country:US
Mailing Address - Phone:360-507-8146
Mailing Address - Fax:360-839-2852
Practice Address - Street 1:2612 YELM HWY SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4826
Practice Address - Country:US
Practice Address - Phone:360-507-8146
Practice Address - Fax:360-839-2852
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP70043574363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health