Individual
CALEY JO DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
5808 W 110TH ST, OVERLAND PARK, KS 66211
(913) 696-8000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-78311-102
KS
Other
Enumeration date
11/25/2018
Last updated
01/23/2020
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