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General NPI Number Information
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NPI Number | 1821661547
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Entity Type | Individual
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Provider Name | NIKKI J GLASS CNP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 822 KUMHO DR STE 101
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City | FAIRLAWN
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State | OH
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Zip | 44333-9298
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Country | US
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Telephone | 330-576-0126
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Fax | 216-649-0551
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 216-468-5000
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Fax | 216-456-8128
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0029590
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License Number State | OH
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