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Individual

JANETTE ANDREA GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
403 S ADAMS ST, SUITE 239, CARTHAGE, IL 62321-1624
(217) 357-0617
(217) 357-0615
Mailing address
PO BOX 160, CARTHAGE, IL 62321-0160
(217) 357-0617
(217) 357-0615

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209004070
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209004070
IL
Enumeration date
11/29/2006
Last updated
09/29/2011
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