Provider Demographics
NPI:1215967435
Name:PEMBER, GLENNA (PA)
Entity type:Individual
Prefix:MS
First Name:GLENNA
Middle Name:
Last Name:PEMBER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8013
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:7950 KIPLING ST
Practice Address - Street 2:STE 101
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3923
Practice Address - Country:US
Practice Address - Phone:303-425-4680
Practice Address - Fax:303-425-1616
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-10-04
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Provider Licenses
StateLicense IDTaxonomies
CO722363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant