| Doctor Name: | ALICIA MAE GLIMSDAL |
| NPI Number: | 1225449192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | R 190448-0 |
| Business Practice Address: | 1257 2nd St N Sauk Rapids, MN - 563794595 |
| Business Phone Number: | 3202414033 |
| Business Fax Number: | 3206546803 |
| Mailing Address: | 1257 2nd St N, SAUK RAPIDS |
| State: | MN |
| Postal Code: | 563794595 |
| Phone Number: | 3202414033 |
| Fax Number: | 3206546803 |
| NPI Enumeration Date: | 05/14/2014 |
| NPI Last Update Date: | 05/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | R 190448-0 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |