| Doctor Name: | MRS. LYNN E GLENN |
| NPI Number: | 1285650515 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 121 |
| Business Practice Address: | 498 North St Bamberg, SC - 290031377 |
| Business Phone Number: | 8032455144 |
| Business Fax Number: | 8032456277 |
| Mailing Address: | Po Box 1245, ORANGEBURG |
| State: | SC |
| Postal Code: | 291161245 |
| Phone Number: | 8033954497 |
| Fax Number: | 8035360998 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 04/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |