Individual
JENNIFER ANN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2060 LAKESIDE CENTRE WAY, SUITE 1, KNOXVILLE, TN 37922-6591
(865) 584-5762
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
100639
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00353091
RR MEDICARE PIN
TN
Enumeration date
08/03/2006
Last updated
05/06/2008
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