Individual
MRS. GLENDA CAROL GULLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
4402 E STATE BLVD, FORT WAYNE, IN 46815-6917
(260) 484-8830
(260) 483-1911
Mailing address
12021 SHEARWATER RUN, FORT WAYNE, IN 46845-8719
(219) 765-8058
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
28124124A
IN
163WX0200X
Oncology Registered Nurse
28124124A
IN
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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