| NPI | 1700990983 |
|---|---|
| Other Name | KELLY RAE GLENN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209000688) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041266672) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 041266672) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-07-21 |