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General NPI Number Information
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NPI Number | 1659871762
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Entity Type | Individual
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Provider Name | HALEY DANAE GLASSER DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 209
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5233
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Country | US
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Telephone | 904-224-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 2054 RIVERSIDE AVE APT 5108
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4447
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Country | US
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Telephone | 678-763-8139
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN260216
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License Number State | GA
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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 | RN260216
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11006222
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License Number State | FL
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