Individual
CHRISTINE GLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
13950 W CAPITOL DR, BROOKFIELD, WI 53005-2441
(414) 302-5400
(414) 302-5495
Mailing address
13950 W CAPITOL DR, BROOKFIELD, WI 53005-2441
(414) 302-5400
(414) 302-5495
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
6014
WI
363LG0600X
Gerontology Nurse Practitioner
6014
WI
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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