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Individual

JENNIFER LEE GLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
Mailing address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
56043
NM

Other

Enumeration date
07/10/2019
Last updated
07/10/2019
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