Individual
GLENDA LYKENS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 NASON DR, ROARING SPRING, PA 16673-1201
(814) 224-5132
(814) 224-2903
Mailing address
100 NASON DR, ROARING SPRING, PA 16673-1201
(814) 224-5132
(814) 224-2903
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP006988B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015716860011
—
PA
01
—
233901
UMW (BLACK LUNG)
PA
01
—
SH928460
HIGHMARK
PA
Enumeration date
09/07/2005
Last updated
07/09/2007
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