Individual
CASEY GLISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13502 HIGHWAY 115 N, MAYNARD, AR 72444-0325
(810) 870-3556
Mailing address
PO BOX 325, MAYNARD, AR 72444-0325
(810) 870-3556
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1099358
TX
390200000X
Student in an Organized Health Care Education/Training Program
R103778
AR
Other
Enumeration date
05/20/2021
Last updated
10/24/2023
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