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NPI Code Detail

MEDICARE: CAYLIE HICKMAN PRS

MEDICARE: CAYLIE HICKMAN PRS
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
1171M00000XCase Manager/Care CoordinatorOH
2175T00000XPeer SpecialistAPS.006261OH

General Provider Information

NPI Number : 1568256832
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAYLIE HICKMAN PRS
Provider Business Mailing Address
First Line : 517 3RD AVE
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1036
Country : US
Telephone Number : 740-451-1455
Fax Number :
Provider Business Practice Location Address
First Line : 517 3RD AVE
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1036
Country : US
Telephone Number : 740-451-1455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2025
Last Update Date : 12/18/2025

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