MEDICARE: MS. DEBORAH F GLASHEEN CRNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	UP006723L	PA

General Provider Information

NPI Number	:	1104853225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH F GLASHEEN CRNP

Provider Business Mailing Address
First Line	:	4131C OREGON PIKE
Second Line	:
City	:	EPHRATA
State	:	PA
Zip	:	17522-9550
Country	:	US
Telephone Number	:	717-859-9902
Fax Number	:	717-859-8774

Provider Business Practice Location Address
First Line	:	4131C OREGON PIKE
Second Line	:
City	:	EPHRATA
State	:	PA
Zip	:	17522-9550
Country	:	US
Telephone Number	:	717-859-9902
Fax Number	:	717-859-8774

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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