MEDICARE: DR. DREXZELL LAANNE GLASKER DNP, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	279012	AZ
2	363LF0000X	Family Nurse Practitioner	95009107	CA
3	363LF0000X	Family Nurse Practitioner	279012	AZ

General Provider Information

NPI Number	:	1063905347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DREXZELL LAANNE GLASKER DNP, FNP

Provider Business Mailing Address
First Line	:	6709 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5110
Country	:	US
Telephone Number	:	520-565-1468
Fax Number	:	888-440-6138

Provider Business Practice Location Address
First Line	:	6709 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5110
Country	:	US
Telephone Number	:	520-565-1468
Fax Number	:	888-440-6138

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	03/02/2026

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