Healthcare Provider Details

I. General information

NPI: 1497735567
Provider Name (Legal Business Name): GAYLE F. GLENNON CNM,ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N CONGRESS AVE STE 200
BOYNTON BEACH FL
33426-3359
US

IV. Provider business mailing address

1301 N CONGRESS AVE STE 200
BOYNTON BEACH FL
33426-3359
US

V. Phone/Fax

Practice location:
  • Phone: 561-742-3929
  • Fax: 561-742-3931
Mailing address:
  • Phone: 561-742-3929
  • Fax: 561-742-3931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP432692
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP432692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: