Individual
TARA S GLASGOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3754
(217) 788-7071
Mailing address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3754
(217) 788-7071
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209000194
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041276945
RN LICENSE
IL
01
—
047565
CCNA CERTIFICATION
—
Enumeration date
04/03/2006
Last updated
08/20/2008
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