Doctor Name: | HILLARY LOUISE GLENN |
NPI Number: | 1649444746 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.R.N.P. |
License Number: | 9274614 |
Business Practice Address: | 45 Sugar Sand Ln Ste A Santa Rosa Beach, FL - 324597482 |
Business Phone Number: | 8505344170 |
Business Fax Number: | 8505344174 |
Mailing Address: | 45 Sugar Sand Ln Ste A, SANTA ROSA BEACH |
State: | FL |
Postal Code: | 324597482 |
Phone Number: | 8505344170 |
Fax Number: | 8505344174 |
NPI Enumeration Date: | 04/18/2008 |
NPI Last Update Date: | 04/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 9274614 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |