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GLENN ISAAC PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 853-0222
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024186629
VA
367500000X
Certified Registered Nurse Anesthetist
201400538
OR
367500000X
Certified Registered Nurse Anesthetist
735992
TX
367500000X
Certified Registered Nurse Anesthetist
APN0000031114
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
87124U
BC/BS
TX
Enumeration date
01/22/2007
Last updated
11/05/2024
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