Individual
DONNA M GLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
500 CONGRESS STREET, SUITE 26, QUINCY, MA 02169
(617) 479-4450
(617) 479-4499
Mailing address
500 CONGRESS STREET, SUITE 2G, QUINCY, MA 02169
(617) 479-4450
(617) 479-4499
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
147054
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356476
—
MA
01
—
GX9967
MEDICARE PTAN #
MA
Enumeration date
07/11/2006
Last updated
08/18/2009
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