Individual
CASANDRA JEAN GLISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-8405
Mailing address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-8405
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000092596
TN
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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