MEDICARE: GLENN ALLEN ARGENTO CNP

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	025417	OH

General Provider Information

NPI Number	:	1316569270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENN ALLEN ARGENTO CNP

Provider Business Mailing Address
First Line	:	10039 BRAXTON DR
Second Line	:
City	:	UNION
State	:	KY
Zip	:	41091-7631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10039 BRAXTON DR
Second Line	:
City	:	UNION
State	:	KY
Zip	:	41091-7631
Country	:	US
Telephone Number	:	216-927-7085
Fax Number	:

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

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	05/14/2020

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