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General NPI Number Information
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NPI Number | 1326508474
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Entity Type | Individual
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Provider Name | ALEXIS LYNN GLOMSKI DO
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Gender | Female
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Dates
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Enumeration Date | 03/24/2019
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 14241 GRAND OAKS DR
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City | BAXTER
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State | MN
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Zip | 56425-8749
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Country | US
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Telephone | 218-316-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 14241 GRAND OAKS DR
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City | BAXTER
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State | MN
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Zip | 56425-8749
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Country | US
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Telephone | 218-316-3101
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 78216
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34.0164712
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License Number State | OH
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