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Individual

SUSAN GLENNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
14121 PARKE LONG CT, SUITE 200 & 201, CHANTILLY, VA 20151-1647
(571) 512-7287
(800) 752-2471
Mailing address
14121 SULLYFIELD CIRCLE, SUITE 201, CHANTILLY, VA 20151-1647
(571) 512-7287
(800) 752-2471

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
147439
MA

Other

Enumeration date
05/01/2013
Last updated
05/01/2013
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