Individual
CHARITY GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
942 COMMONWEALTH BLVD, TUPELO, MS 38804-9762
(662) 620-0101
(662) 620-0090
Mailing address
942 COMMONWEALTH BLVD, TUPELO, MS 38804-9762
(662) 620-0101
(662) 620-0090
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
904510
MS
Other
Enumeration date
03/30/2021
Last updated
05/30/2023
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