Individual provider · Type 1 NPI

Glenn Hickman, NP

Family Nurse Practitioner · Modesto, CA

NPI number 1972064913 Active

Practice location

4601 Dale Rd
Modesto, CA 95356-9718

Mailing address

1333 Marisol Dr
Manteca, CA 95337-8791

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95011508 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1972064913

Glenn Hickman, NP's National Provider Identifier is 1972064913, issued on Mar 30, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Modesto, CA. The record was last updated on Feb 4, 2022.