Individual
GLENN A HOUSE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 649-8767
Mailing address
120 INNWOOD DR, COVINGTON, LA 70433-9123
(985) 649-8767
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN066203
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014222
—
LA
Enumeration date
07/30/2007
Last updated
10/02/2020
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