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Individual

PATRICIA L GLENN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2018 W CLINCH AVE, KNOXVILLE, TN 37916-2301
(865) 541-8485
(865) 541-8727
Mailing address
PO BOX 15010, KNOXVILLE, TN 37901-5010
(865) 541-8485
(865) 541-8727

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
71142
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100047159
PHP TENNCARE
TN
05
3634024
TN
01
4100944
BLUECARE
TN
01
P00193844
TRAVELERS MEDICARE
TN
Enumeration date
04/10/2006
Last updated
03/24/2011
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