MEDICARE: MISS TAHNEE GLENN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	347C00000X	Private Vehicle
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1629686266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TAHNEE GLENN

Provider Business Mailing Address
First Line	:	1618 ORLEANS CIR APT 1C
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-3345
Country	:	US
Telephone Number	:	816-872-9337
Fax Number	:

Provider Business Practice Location Address
First Line	:	1618 ORLEANS CIR APT 1C
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-3345
Country	:	US
Telephone Number	:	816-872-9337
Fax Number	:

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

Provider Enumeration Date	:	07/20/2020
Last Update Date	:	07/20/2020

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Directions to “ MISS TAHNEE GLENN ” Practice Location

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