Individual
MRS. DEBRA LYNN GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3500 OLD WASHINGTON RD, SUITE302, WALDORF, MD 20602-3224
(301) 645-8867
(301) 645-2330
Mailing address
23295 LAKEVIEW DR, CALIFORNIA, MD 20619-4206
(817) 366-8817
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R201736
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8L6698
MEDICARE PTAN
TX
Enumeration date
11/18/2005
Last updated
11/21/2013
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