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General NPI Number Information
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NPI Number | 1003886722
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Entity Type | Individual
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Provider Name | PAMELA S.F. GLENN
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1200 LAGOON AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-2077
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Country | US
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Telephone | 612-823-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 6440 BALLANTINE CT
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55077-2163
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Country | US
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Telephone | 651-552-9454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | R117394-9
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | R034727
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | CM000036
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License Number State | SD
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