Individual
DR. LYNN E GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, PHD
Contact information
Practice address
904 MERRY ST, AUGUSTA, GA 30904-3839
(706) 721-1121
Mailing address
895 TRAIL RIDGE RD, AIKEN, SC 29803-7767
(803) 707-2704
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000341
GA
363LF0000X
Family Nurse Practitioner
121
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121
LICENSE NUMBER
SC
01
—
GAA-NP000341
GA NP LICENSE NUMBER
GA
Enumeration date
07/13/2006
Last updated
09/03/2023
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