Provider Demographics
NPI:1528165073
Name:GLENNON, NIKKI BELL (PA-C)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:BELL
Last Name:GLENNON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:CARESPOT OF ORLANO-APOPKA
Mailing Address - Street 2:3840 EAST STATE ROAD 436 SUITE 1000
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703
Mailing Address - Country:US
Mailing Address - Phone:407-478-3202
Mailing Address - Fax:407-478-3245
Practice Address - Street 1:CARESPOT OF ORLANO-APOPKA
Practice Address - Street 2:3840 EAST STATE ROAD 436 SUITE 1000
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703
Practice Address - Country:US
Practice Address - Phone:407-478-3202
Practice Address - Fax:407-478-3245
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2020-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH0370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant