Provider Demographics
NPI:1336430057
Name:HICKMAN, SHERRY (NP)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22490 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1529
Mailing Address - Country:US
Mailing Address - Phone:281-813-2704
Mailing Address - Fax:
Practice Address - Street 1:22490 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1529
Practice Address - Country:US
Practice Address - Phone:281-813-2704
Practice Address - Fax:888-241-3025
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX673199363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673199OtherTEXAS BOARD OF NURSING