Individual
NICOLE ROUSE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5531 ELEANOR ROOSEVELT LN, WILLARD, NC 28478-6621
(910) 376-0633
Mailing address
5531 ELEANOR ROOSEVELT LN, WILLARD, NC 28478-6621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5020318
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2022
Last updated
08/22/2024
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