MEDICARE: DANNAH YISRAEL 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1750239307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNAH YISRAEL HICKS

Provider Business Mailing Address
First Line	:	1907 LAWN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-6125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1907 LAWN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-6125
Country	:	US
Telephone Number	:	404-786-7231
Fax Number	:

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

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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