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Individual

MRS. NICOLE LYNN HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
716 WAYFIELD CT, BEAVERCREEK, OH 45430-1476
(937) 304-5163
Mailing address
716 WAYFIELD CT, BEAVERCREEK, OH 45430-1476
(937) 304-5163

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
374J00000X
Doula
374U00000X
Home Health Aide

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2904842
OH
Enumeration date
12/22/2020
Last updated
10/18/2022
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