Provider Demographics
NPI:1063777456
Name:ROBIN RICKS
Entity type:Organization
Organization Name:ROBIN RICKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUSRSE AIDE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-692-8266
Mailing Address - Street 1:2835 SHAFFER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7114
Mailing Address - Country:US
Mailing Address - Phone:513-692-8266
Mailing Address - Fax:
Practice Address - Street 1:2835 SHAFFER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7114
Practice Address - Country:US
Practice Address - Phone:513-692-8266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4002198603033140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric