Individual
GLENN P THOMASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2430 EMERALD PL, SUITE 201, GREENVILLE, NC 27834-5784
(252) 752-2140
(252) 752-3949
Mailing address
2430 EMERALD PL, SUITE 201, GREENVILLE, NC 27834-5784
(252) 752-2140
(252) 752-3949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
118027
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
073405
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052825
—
NC
01
—
P00601428
RAILROAD MEDICARE
NC
Enumeration date
01/12/2007
Last updated
06/11/2010
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