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Individual
MS. GLENNA RAE TOLLEY
Active
Individual
MS. GLENNA RAE TOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
462400
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197009704
—
TX
01
—
835N17
BCBS TX
TX
01
—
P00885674
RR MCR
TX
Enumeration date
05/08/2008
Last updated
01/19/2016
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