Individual
JAMES M GLISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
601 E MATTHEWS AVE, JONESBORO, AR 72401-3145
(870) 935-6396
(870) 935-4063
Mailing address
601 E MATTHEWS AVE, JONESBORO, AR 72401-3145
(870) 935-6396
(870) 935-4063
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00617
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119075701
—
AR
01
—
430019968
RAILROAD MEDICARE
AR
01
—
596897933
MEDICARE ID-TYPE UNSPECIFIED
AR
01
—
917773608
MISSOURI MEDICAID
MO
Enumeration date
07/28/2006
Last updated
04/29/2008
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