Individual
MS. MONA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
325110
NC
163WP2201X
Ambulatory Care Registered Nurse
325110
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012574
MILITARY
GA
Enumeration date
09/03/2020
Last updated
09/03/2020
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