Individual
JAMES M GLISSON
Active
Individual
JAMES M GLISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
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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