Individual provider Active NPI

Pamela S.F. Glenn

  • Advanced Practice Midwife
  • Minneapolis, MN
National Provider Identifier
1003886722
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R117394-9 Issued in MN
Practice address
1200 Lagoon Ave
Minneapolis, MN 55408-2077
Phone
(612) 823-6300
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R117394-9 MN Primary
Advanced Practice Midwife 367A00000X R034727 SD
Advanced Practice Midwife 367A00000X CM000036 SD

Addresses

Primary practice location

1200 Lagoon Ave
Minneapolis, MN 55408-2077

Mailing address

6440 Ballantine CT
Inver Grove Heights, MN 55077-2163
Phone (651) 552-9454

Other identifiers 7

IdentifierTypeStateIssuer
1018938OtherPREFERRED ONE
2300764OtherAMERICA'S PPO (ARAZ)
41553OtherSIOUX VALLEY HEALTH PLAN
HP16279OtherHEALTH PARTNERS
07-04217OtherMEDICA
107235OtherUCARE
408L7GLOtherMNBCBS MN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R117394-9MNMDAdvanced Practice Midwife
CM000036SDMDAdvanced Practice Midwife
R034727SDMDAdvanced Practice Midwife

Interoperability endpoints

  • Direct secure messaging: pamela.glenn.1@10306.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003886722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 BALLANTINE CT",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550772163",
            "telephone_number": "651-552-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAGOON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082077",
            "telephone_number": "612-823-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "PAMELA",
        "middle_name": "S.F.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R117394-9",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SD",
            "license": "R034727",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SD",
            "license": "CM000036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1018938",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO (ARAZ)",
            "identifier": "2300764",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "41553",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP16279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "07-04217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "107235",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "408L7GL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.