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NPI Code Detail

MEDICARE: KAREN GLAVIN PA-C

MEDICARE: KAREN GLAVIN PA-C
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
1363A00000XPhysician Assistant4517-23WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700868239
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN GLAVIN PA-C
Provider Business Mailing Address
First Line : PO BOX 5210
Second Line :
City : GRAND FORKS
State : ND
Zip : 58206-5210
Country : US
Telephone Number : 701-205-3000
Fax Number : 701-732-2501
Provider Business Practice Location Address
First Line : 3674 S WASHINGTON ST
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5766
Country : US
Telephone Number : 701-205-3000
Fax Number : 701-732-2501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 01/22/2026

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Directions to “ KAREN GLAVIN PA-C” Practice Location

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