Healthcare Provider Details

I. General information

NPI: 1538064886
Provider Name (Legal Business Name): REBECCA GLASSBURN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E HANNA AVE
INDIANAPOLIS IN
46227-3630
US

IV. Provider business mailing address

1400 E HANNA AVE
INDIANAPOLIS IN
46227-3630
US

V. Phone/Fax

Practice location:
  • Phone: 317-788-3368
  • Fax:
Mailing address:
  • Phone: 317-788-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF10260042
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: