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General NPI Number Information
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NPI Number | 1891040135
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Entity Type | Individual
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Provider Name | ANNE BRIDGET GLEASON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 270 EAST 223RD ST SOUTH BAY FAMILY HEALTH CARE
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City | CARSON
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State | CA
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Zip | 90745
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Country | US
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Telephone | 310-549-7259
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Fax |
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Provider Business Mailing Address
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Address Line | 270 EAST 223RD ST SOUTH BAY FAMILY HEALTH CARE
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City | CARSON
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State | CA
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Zip | 90745
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Country | US
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Telephone | 310-549-7259
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2274503
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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 | 22900
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License Number State | CA
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