Individual
SUSAN RENA GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2029 VALLEYGATE DR, SUITE 101, FAYETTEVILLE, NC 28304-3688
(910) 323-2103
(910) 323-2219
Mailing address
2029 VALLEYGATE DR, SUITE 101, FAYETTEVILLE, NC 28304-3688
(910) 323-2103
(910) 323-2219
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
200863
NC
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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