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General NPI Number Information
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NPI Number | 1447919535
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Entity Type | Individual
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Provider Name | EDWARD CHARLES GLAZEBROOK MS, RN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 19 TACOMA ST
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City | WORCESTER
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State | MA
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Zip | 01605-3516
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Country | US
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Telephone | 508-852-1805
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Fax |
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Provider Business Mailing Address
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Address Line | 10 FERRY ST STE 302
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City | CONCORD
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State | NH
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Zip | 03301-5081
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Country | US
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Telephone | 603-333-1471
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Fax | 603-255-7286
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2357058
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2357058
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2357058
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License Number State | MA
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