Individual
STEFANIE MARIE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5633
Mailing address
10 CENTER DRIVE MSC 1450, B10 CRC RM 5-5750, BETHESDA, MD 20792-1268
(301) 451-9946
(301) 451-6989
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R135489
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402638100
—
MD
Enumeration date
06/02/2006
Last updated
12/13/2010
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