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General NPI Number Information
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NPI Number | 1336506773
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Entity Type | Individual
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Provider Name | MEGHAN BROOKE GLASCOCK CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 2905 PINE MILL RD
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City | PARIS
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State | TX
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Zip | 75460-3469
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Country | US
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Telephone | 903-905-4717
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1072
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City | PARIS
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State | TX
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Zip | 75461-1072
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Country | US
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Telephone | 903-366-3349
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP130009
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License Number State | TX
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