Individual
KATHLEEN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
252 S 4TH ST, LEBANON, PA 17042-6111
(717) 851-2613
(717) 798-3677
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
SP016649
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP016649
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037625810001
—
PA
Enumeration date
04/08/2020
Last updated
11/03/2025
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