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Individual

MRS. ROMIKA TANELLE GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, NP-C

Contact information

Practice address
2025 FORT ST, WYANDOTTE, MI 48192-3841
(734) 320-0525
Mailing address
8864 GROVER ST, ROMULUS, MI 48174-4124
(734) 331-2494

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704218454
MI
363LF0000X
Family Nurse Practitioner
Primary
4704218454
MI

Other

Enumeration date
10/19/2010
Last updated
02/07/2020
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