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Individual

MS. MONA GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
WINN ARMY COMMUNITY HOSPITAL, 1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 315-6116
Mailing address
1061 HARMON AVE OFC, FORT STEWART, GA 31314-5641
(912) 315-6116

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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