Provider Demographics
NPI:1063668564
Name:GLENN, ROBIN M (RN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:M
Last Name:GLENN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:415 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1656
Mailing Address - Country:US
Mailing Address - Phone:812-464-0521
Mailing Address - Fax:812-464-0565
Practice Address - Street 1:1138 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2715
Practice Address - Country:US
Practice Address - Phone:270-827-8811
Practice Address - Fax:812-464-0565
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY109778163WM0705X
IN28165798A163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical