Provider Demographics
NPI:1467457374
Name:FIKES, DEBRA KAY (ACNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:FIKES
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:C
Other - Last Name:FIKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACNP
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-6341
Mailing Address - Fax:239-343-6342
Practice Address - Street 1:9981 S HEALTHPARK DR STE 156
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-343-6341
Practice Address - Fax:239-343-6342
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9487292363LA2100X
GARN126896NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA617334071AMedicaid
GA617334071GMedicaid
GA617334071CMedicaid
GA617334071HMedicaid
GA617334071IMedicaid
FL110749500Medicaid
GA617334071BMedicaid
GA511I500329OtherMEDICARE PART B