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General NPI Number Information
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NPI Number | 1821220062
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Entity Type | Individual
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Provider Name | KIMBERLY M GLOW M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 116 AGNES RD STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37919-6306
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Country | US
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Telephone | 865-229-6575
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Fax | 217-215-9876
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Provider Business Mailing Address
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Address Line | 116 AGNES RD STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37919-6306
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Country | US
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Telephone | 217-369-7878
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DR.0062432
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 036102300
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 68798
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License Number State | TN
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