Individual
MR. JERVIA ISHUM SIMON FICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
NAVAL HOSPITAL LEMOORE, 937 FRANKLIN AVE, LEMOORE, CA 93246-5004
(559) 998-4208
Mailing address
NAVAL HOSPITAL LEMOORE, 937 FRANKLIN AVE, LEMOORE, CA 93246-5004
(559) 998-4208
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
22451
CA
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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