Individual
MRS. DIANE CAROL GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C, SANE
Contact information
Practice address
375 WEAVER RD, FLORENCE, KY 41042-2998
(859) 111-1111
Mailing address
375 WEAVER RD, FLORENCE, KY 41042-2998
(859) 282-9390
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013011
KY
363LF0000X
Family Nurse Practitioner
3013011
KY
Other
Enumeration date
02/04/2019
Last updated
06/11/2019
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