Individual
JESSICA SUE GLACKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1525 W CYPRESS CREEK RD, FORT LAUDERDALE, FL 33309-1831
(954) 504-5074
Mailing address
5253 DENVER ST NE, SAINT PETERSBURG, FL 33703-3228
(727) 390-7075
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11026665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118728200
—
FL
Enumeration date
02/27/2023
Last updated
02/03/2025
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