Individual
GLENNA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 SUTHERLAND AVE, INDIANAPOLIS, IN 46205-4632
(317) 499-7705
Mailing address
3025 SUTHERLAND AVE, INDIANAPOLIS, IN 46205-4632
(317) 499-7705
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
18-014293-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017693
—
IN
Enumeration date
11/05/2018
Last updated
11/05/2018
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