Provider Demographics
NPI:1265956585
Name:FLICK, JENNIFER CARRIE
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CARRIE
Last Name:FLICK
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 1:3711 HUTTON ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2307
Mailing Address - Country:US
Mailing Address - Phone:513-485-8809
Mailing Address - Fax:
Practice Address - Street 1:3711 HUTTON ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226
Practice Address - Country:US
Practice Address - Phone:513-485-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide