Individual
MRS. CRYSTAL LYNN GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
952 W MAIN ST, NEWARK, OH 43055-2526
(740) 344-9289
Mailing address
952 W MAIN ST, NEWARK, OH 43055-2526
(740) 344-9289
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 111657-MEDS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2683798
—
OH
Enumeration date
11/01/2006
Last updated
07/09/2007
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