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Individual

GLENN PARKER

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1060 GAFFNEY RD, BASSETT ARMY COMMUNITY HOSPITAL, FT WAINWRIGHT, AK 99703-5001
(907) 353-5418
(907) 353-4845
Mailing address
1060 GAFFNEY RD, COMMANDER, USA-MEDDAC-AK, ATTN: MCUC-MMD-QM, FT WAINWRIGHT, AK 99703-5001
(907) 353-5418
(907) 353-4845

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
184648
TX

Other

Enumeration date
12/13/2005
Last updated
07/08/2007
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