Individual
MR. GLENN W MCLENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-1661
(573) 302-1719
Mailing address
PO BOX 840, OSAGE BEACH, MO 65065-0840
(573) 302-1661
(573) 302-1719
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2006004784
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093963159
—
MO
Enumeration date
09/03/2008
Last updated
09/08/2015
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