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General NPI Number Information
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NPI Number | 1033148507
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Entity Type | Individual
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Provider Name | KERSTIN M GLYNN MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 1412 N 2ND ST
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City | ATCHISON
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State | KS
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Zip | 66002
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Country | US
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Telephone | 913-367-4879
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Fax |
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Provider Business Mailing Address
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Address Line | 303 S 1ST ST
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City | SABETHA
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State | KS
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Zip | 66534-2801
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Country | US
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Telephone | 785-285-0921
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-29719
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0429719
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License Number State | KS
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