Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Glenn Hickman, NP

Individual provider Family Nurse Practitioner · NPI 1972064913

Glenn Hickman, NP is a Nurse Practitioner in Modesto, California. Qualified in 2018, 8 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2019
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4601 Dale Rd
Modesto, CA 95356-9718
Phone: (209) 735-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95011508 (CA)

Record details

NPI number1972064913
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorYes
NPI enumeratedMarch 30, 2019
Last updated in NPPESFebruary 4, 2022
Mailing address1333 Marisol Dr, Manteca, CA 95337-8791

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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