Individual
DOMINIQUE DANIELLE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, AGACNP-BC
Contact information
Practice address
48 CENTENNIAL WAY, GREENVILLE, SC 29605-4662
(864) 522-8000
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
31139
SC
363LA2200X
Adult Health Nurse Practitioner
Primary
31139
SC
Other
Enumeration date
11/04/2025
Last updated
04/22/2026
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