Individual provider Active NPI

Robin M Glenn, RN

  • Medical-Surgical Registered Nurse
  • Henderson, KY
National Provider Identifier
1063668564
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
28165798A Issued in IN
Practice address
1138 N Elm St
Henderson, KY 42420-2715
Phone
(270) 827-8811
Fax
(812) 464-0565
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 109778 KY
Medical-Surgical Registered Nurse 163WM0705X 28165798A IN Primary

Addresses

Primary practice location

1138 N Elm St
Henderson, KY 42420-2715

Mailing address

415 W Columbia St
Evansville, IN 47710-1656
Phone (812) 464-0521

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28165798AINMDMedical-Surgical Registered Nurse
109778KYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1063668564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101656",
            "telephone_number": "812-464-0521",
            "fax_number": "812-464-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202715",
            "telephone_number": "270-827-8811",
            "fax_number": "812-464-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "ROBIN",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "KY",
            "license": "109778",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "IN",
            "license": "28165798A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.