Provider Demographics
NPI:1407600745
Name:HICKS, REBEKAH LOUISE
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LOUISE
Last Name:HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CLIFFVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1102
Mailing Address - Country:US
Mailing Address - Phone:859-640-5383
Mailing Address - Fax:
Practice Address - Street 1:1404 TUSCARORA DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2454
Practice Address - Country:US
Practice Address - Phone:513-309-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care