Individual
STACEY ANNE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, HWNC-BC
Contact information
Practice address
900 NORTHCREST DR # 294, CRESCENT CITY, CA 95531-2315
(530) 488-0250
Mailing address
900 NORTHCREST DR # 294, CRESCENT CITY, CA 95531-2315
(530) 488-0250
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95134873
CA
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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