Individual
DR. BRENDAN GLOWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC, CRNP-FAMILY
Contact information
Practice address
985 PRINCE FREDERICK BLVD, SUITE 201, PRINCE FREDERICK, MD 20678-3492
(410) 535-2005
(410) 535-4850
Mailing address
985 PRINCE FREDERICK BLVD, SUITE 201, PRINCE FREDERICK, MD 20678-3492
(410) 414-5302
(443) 432-3683
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R216694
MD
363LF0000X
Family Nurse Practitioner
Primary
R216694
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192205000
—
MD
Enumeration date
08/06/2019
Last updated
08/25/2022
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