Doctor Name: | GLEN CHARLES NOBLES |
NPI Number: | 1467875005 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP-C |
License Number: | ARNP 9320777 |
Business Practice Address: | 1338 South Blvd Chipley, FL - 324281846 |
Business Phone Number: | 8506386240 |
Business Fax Number: | 8504155010 |
Mailing Address: | 1338 South Blvd, CHIPLEY |
State: | FL |
Postal Code: | 324281846 |
Phone Number: | 8506386240 |
Fax Number: | 8504155010 |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 05/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP 9320777 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |