Individual
MS. REGINA B GLISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN-C
Contact information
Practice address
645 NEPTUNE BLVD, NEPTUNE, NJ 07753-4118
(732) 858-4351
Mailing address
2 ALFRED CT, NEPTUNE, NJ 07753-2822
(732) 858-4351
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00412300
NJ
363LA2200X
Adult Health Nurse Practitioner
26NJ00412300
NJ
363LA2200X
Adult Health Nurse Practitioner
F310694-01
NY
Other
Enumeration date
12/31/2012
Last updated
12/20/2023
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