Healthcare Provider Details

I. General information

NPI: 1134250996
Provider Name (Legal Business Name): KRISTINA RUTH GLASCO-JEWELL RNMS CS-P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTINE RUTH GLASCO RNMS CS-P

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 COLESVILLE RD
SILVER SPRING MD
20901-4843
US

IV. Provider business mailing address

338 RIVERSIDE ROAD
EDGEWATER MD
21037
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-8861
  • Fax: 301-585-3868
Mailing address:
  • Phone: 410-997-7907
  • Fax: 301-585-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number0001197850
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR067757
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberAC000257
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: