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HEATHER MICHELLE GLIEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
300 UTAH ST FL 2, HIAWATHA, KS 66434-2314
(785) 742-2161
(785) 742-6554
Mailing address
300 UTAH ST, HIAWATHA, KS 66434-2314
(785) 742-2131

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02140
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201223150A
KS
Enumeration date
09/22/2018
Last updated
08/26/2019
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