Individual
MARJERNELL HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
2498 STEVENS CREEK BLVD, SAN JOSE, CA 95128-1652
(408) 998-5400
(408) 998-5414
Mailing address
225 PAMELA DR APT 16, MOUNTAIN VIEW, CA 94040-3235
(803) 360-1268
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95032891
CA
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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