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Individual

ANGELA L GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2101 CORONA RD STE 102, COLUMBIA, MO 65203-2582
(573) 234-1800
Mailing address
2101 CORONA RD STE 102, COLUMBIA, MO 65203-2582
(573) 234-1800

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019005397
MO
363LF0000X
Family Nurse Practitioner
2019005397
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2019005397
FNP
MO
Enumeration date
03/04/2019
Last updated
07/21/2023
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