Individual
CECELIA SHEPHERD GLENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, RN
Contact information
Practice address
300 PASTEUR DR, SUMC - PEDS PHYSICIAN BILLING MC: 5530, STANFORD, CA 94305-2200
(650) 498-7391
(650) 725-7888
Mailing address
300 PASTEUR DR, SUMC - PEDS PHYSICIAN BILLING MC: 5530, STANFORD, CA 94305-2200
(650) 498-7391
(650) 725-7888
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
461450
CA
363LP0200X
Pediatric Nurse Practitioner
NP7406
CA
Other
Enumeration date
05/05/2010
Last updated
09/26/2012
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