Provider Demographics
NPI:1760076814
Name:SHICKS, ANNA T
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:T
Last Name:SHICKS
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 1:1723 ROME CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9447
Mailing Address - Country:US
Mailing Address - Phone:614-270-2065
Mailing Address - Fax:
Practice Address - Street 1:343 POTAWATOMI DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2380
Practice Address - Country:US
Practice Address - Phone:614-800-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide