Provider Demographics
NPI:1659695112
Name:DICKEY, ERIN M (FNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:DICKEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2790 CLAY EDWARDS DR STE 650
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3279
Mailing Address - Country:US
Mailing Address - Phone:816-459-7500
Mailing Address - Fax:816-459-9611
Practice Address - Street 1:120 NE SAINT LUKES BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6011
Practice Address - Country:US
Practice Address - Phone:816-246-4302
Practice Address - Fax:816-246-9493
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010009929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1659695112Medicaid
MO540568508Medicaid
MO595985805Medicaid
MO595956103Medicaid
MO1659695112Medicaid
43672011OtherBCBS
43672011OtherBCBS
MO595956103Medicaid
MO595985805Medicaid
43672021OtherBCBS