Healthcare Provider Details

I. General information

NPI: 1154207223
Provider Name (Legal Business Name): SARAH GLENN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

IV. Provider business mailing address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number82089
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: