MEDICARE: AMY R GLASSMAN MS, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95002783	CA

General Provider Information

NPI Number	:	1053796482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY R GLASSMAN MS, FNP

Provider Business Mailing Address
First Line	:	3332 VIA VERDE TER
Second Line	:
City	:	DAVIS
State	:	CA
Zip	:	95618-6747
Country	:	US
Telephone Number	:	530-665-9251
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2201
Country	:	US
Telephone Number	:	916-734-2011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2015
Last Update Date	:	05/05/2026

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