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:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14049 VUE ST SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-5924
Mailing Address - Country:US
Mailing Address - Phone:360-790-7770
Mailing Address - Fax:
Practice Address - Street 1:14049 VUE ST SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-5924
Practice Address - Country:US
Practice Address - Phone:360-790-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program