Provider Demographics
NPI:1790038388
Name:HICKS, SAUNDRA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:SAUNDRA
Middle Name:MARIE
Last Name:HICKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:7098 HAYES ROAD
Mailing Address - City:ANDOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44003-1053
Mailing Address - Country:US
Mailing Address - Phone:440-417-6023
Mailing Address - Fax:
Practice Address - Street 1:7098 HAYES RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9744
Practice Address - Country:US
Practice Address - Phone:440-417-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN299637163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse