Provider Demographics
NPI:1093120123
Name:HICKS, BEATRICE ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:ANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:BEATRICE
Other - Middle Name:ANN
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1058 BLUE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2810
Mailing Address - Country:US
Mailing Address - Phone:740-454-4836
Mailing Address - Fax:
Practice Address - Street 1:1058 BLUE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2810
Practice Address - Country:US
Practice Address - Phone:740-454-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.157336163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health