Provider Demographics
NPI:1033530894
Name:SIKES, KATIE ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:ANN
Last Name:SIKES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:ANN
Other - Last Name:CICALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3955 PATIENT CARE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4299
Mailing Address - Country:US
Mailing Address - Phone:517-882-6643
Mailing Address - Fax:
Practice Address - Street 1:3955 PATIENT CARE DR
Practice Address - Street 2:SUITE B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4299
Practice Address - Country:US
Practice Address - Phone:517-882-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-21
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704253048363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner