Individual
SHANIKA NICOLE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 326-4396
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 326-4396
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN202113
GA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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