Individual
MISS CIARA GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-3390
(314) 617-2113
Mailing address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085008403
IL
363AS0400X
Surgical Physician Assistant
Primary
2021009905
MO
Other
Enumeration date
04/03/2020
Last updated
05/07/2025
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