Provider Demographics
NPI:1093937302
Name:HICKS, ROBIN LEE
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LEE
Last Name:HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:LEE
Other - Last Name:RITCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315A HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055
Mailing Address - Country:US
Mailing Address - Phone:740-323-4456
Mailing Address - Fax:740-323-4456
Practice Address - Street 1:315A HUDSON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055
Practice Address - Country:US
Practice Address - Phone:740-323-4456
Practice Address - Fax:740-323-4456
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
2189028Medicare UPIN