Individual
MR. GLENN WILSON LANCLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1151 MARGUERITE ST, MORGAN CITY, LA 70380-1850
(985) 380-2200
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP05639
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2336720
—
LA
Enumeration date
11/04/2008
Last updated
09/20/2021
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