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Individual

DAWN HOLLEY KIKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4711 POPLAR SPRINGS DR, MERIDIAN, MS 39305-2622
(601) 425-7777
Mailing address
9425 EASTSIDE DRIVE EXT, SUITE A, NEWTON, MS 39345-8068
(601) 635-3333
(601) 635-3330

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R863932
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00925081
MEDICAID GROUP MERIDIAN
MS
01
04278332
MEDICAID GROUP NEWTON
MS
01
25-3808
MEDICARE NEWTON OFFICE
01
25-3841
MEDICARE MERIDIAN OFFICE
05
5859009
MS
Enumeration date
07/31/2009
Last updated
04/25/2013
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