Basic Information
Provider Information
NPI: 1407861107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HICKMAN
FirstName: FRANCES
MiddleName: CABRINI
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 156 COUNTRYHAVEN RD
Address2:  
City: ENCINITAS
State: CA
PostalCode: 920243102
CountryCode: US
TelephoneNumber: 8582014342
FaxNumber:  
Practice Location
Address1: 3350 LA JOLLA VILLAGE DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921610002
CountryCode: US
TelephoneNumber: 8585528585
FaxNumber: 8586426255
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XFNP 7985CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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