MEDICARE: ANGELA HICKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WI0500X	Infusion Therapy Registered Nurse	346461	OH

General Provider Information

NPI Number	:	1831548452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA HICKS

Provider Business Mailing Address
First Line	:	3002 GILBERT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1021
Country	:	US
Telephone Number	:	513-655-0046
Fax Number	:

Provider Business Practice Location Address
First Line	:	3002 GILBERT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1021
Country	:	US
Telephone Number	:	513-655-0046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2016
Last Update Date	:	06/04/2016

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Directions to “ ANGELA HICKS ” Practice Location

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