KACEY JO KIKER (NPI# 1528464054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528464054 |
| Entity Type | Individual |
| Full Name | KACEY JO KIKER |
| Credential | APRN, NP-C |
| Practice Address |
620 W South St Benton AR 72015 |
| Mailing Address |
Po Box 497 Augusta AR 72006-0497 |
| Practice Telephone | 8703472534 |
| Practice Fax Number | 8703472023 |
| Mailing Telephone | 8703472534 |
| Mailing Fax Number | 8703472023 |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A004088 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 206200758 | 05 |
| Street Address |
620 W SOUTH ST |
| City | BENTON |
| State | AR |
| Zip Code | 72015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506056 | James Zackary Haley | Pharmacist | 620 W South St, Benton, AR 72015-4258 | 2020-10-20 |
| 1366060576 | West Side Pharmacy, Inc. | Family Medicine | 620 W South St, Benton, AR 72015-4258 | 2020-07-14 |
| 1417579970 | Tammi Sue Haley | Pharmacist | 620 W South St, Benton, AR 72015-4258 | 2020-05-07 |
| 1952949448 | Allie Danielle Staton | Pharmacist | 620 W South St, Benton, AR 72015-4258 | 2019-12-15 |
| 1144870957 | West Side Pharmacy Inc. | Pharmacy | 620 W South St, Benton, AR 72015-4258 | 2019-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
| 1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
| 1265708945 | Tracey Leigh Zeiner | Occupational Therapist | 5701 Springhill Road, Bryant, AR 72015 | 2012-03-28 |
| Find all providers in zip 72015 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
| 1538625900 | Morgan Dyanne Colson | Nurse Practitioner | 1576 Brookshire Dr, Benton, AR 72019-9547 | 2019-02-11 |
| 1639648041 | Laurie Jeannette Kerschner | Nurse Practitioner | 166 Wellivers Hill Rd, Benton, PA 17814-8131 | 2018-11-14 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1982171484 | Reanna Christine Hargrove | Nurse Practitioner | 2314 Olive Creek Rd, Benton, KY 42025-4208 | 2018-11-01 |
| 1710474093 | Carmacare Inc | Nurse Practitioner | 2408 Military Rd, Benton, AR 72015-2743 | 2018-04-23 |
| 1366950693 | Blake Borders | Nurse Practitioner | 222 Bland St, Benton, MO 63736-9206 | 2018-01-22 |
| 1063920452 | Pamela Ann Bates | Nurse Practitioner | 824 Military Rd, Benton, AR 72015-3347 | 2018-01-19 |
| 1023525490 | Kortney Kai Spann | Nurse Practitioner | 4110 Darla Dr, Benton, AR 72015-6299 | 2018-01-05 |
| 1548791510 | Monica Suzanne Williams | Nurse Practitioner | 10676 Hinds Rd, Benton, AR 72019-9442 | 2017-03-22 |
| Find all providers in BENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.