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General NPI Number Information
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NPI Number | 1134184294
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Entity Type | Individual
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Provider Name | GLENNA CAROLYN THORNSBURY FNP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | RT 460
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City | OAKWOOD
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State | VA
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Zip | 24631
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Country | US
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Telephone | 276-498-3135
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Fax | 276-498-7257
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Provider Business Mailing Address
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Address Line | PO BOX 900
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City | RICHLANDS
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State | VA
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Zip | 24641
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Country | US
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Telephone | 276-964-9102
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Fax | 276-963-2865
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024073938
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License Number State | VA
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