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Glenn Hickman, NP
Family Nurse Practitioner in Modesto, California
NPI 1972064913

Glenn Hickman is a Family Nurse Practitioner based in Manteca, CA and is specialized in Family. Glenn Hickman practices in Modesto, CA and has the professional credentials of NP. The NPI Number for Glenn Hickman is 1972064913 and holds a License No. 95011508 (California).

The current practice location address for Glenn Hickman is 4601 Dale Rd, Modesto, CA and can be reached out via phone at 209-735-5000.

Location: 4601 Dale Rd, Modesto, CA, 95337-8791
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972064913
Provider Name
Glenn Hickman
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
4601 Dale Rd, Modesto, CA, 95337-8791
Phone Number
209-735-5000
Fax Number
Provider Enumeration Date
03/30/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4601 Dale Rd
City
Modesto
State
California
Zip
95356-9718
Phone Number
209-735-5000
Fax Number
person
Provider Business Mailing Address Details
Address
4601 Dale Rd
City
Modesto
State
California
Zip
95356-9718
Phone Number
209-735-5000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
95011508 (California)
Definition
Definition to come...
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