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Individual
DANIELLE GLICK
Active
Individual
DANIELLE GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001659A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003675
—
IN
01
—
P02259017
RR MEDICARE
IN
Enumeration date
06/13/2014
Last updated
11/27/2023
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