Provider Demographics
NPI:1639434392
Name:HICKMAN, DENISE FLORES (RN, MSN, CPNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:FLORES
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 BABCOCK RD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6028
Mailing Address - Country:US
Mailing Address - Phone:956-504-6080
Mailing Address - Fax:210-949-5051
Practice Address - Street 1:2829 BABCOCK RD
Practice Address - Street 2:SUITE 407
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6028
Practice Address - Country:US
Practice Address - Phone:210-614-5437
Practice Address - Fax:210-949-5051
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX651574363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics