Provider Demographics
NPI:1992044895
Name:GLENN, ZANDRA M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ZANDRA
Middle Name:M
Last Name:GLENN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3361 CAMERON CHASE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2897
Mailing Address - Country:US
Mailing Address - Phone:850-942-9423
Mailing Address - Fax:
Practice Address - Street 1:2009 W TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-3116
Practice Address - Country:US
Practice Address - Phone:850-942-9423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0027981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist