Active NPI
Edna Anna Glassman-Lackow, RN
- Health & Wellness Coach
- Lewes, DE
National Provider Identifier
1265122139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- L1-0068815
- Practice address
- 424 Savannah Rd
Lewes, DE 19958-1462 - Phone
- (914) 494-1975
- NPI assigned
- May 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | L1-0068815 | DE | Primary |
Addresses
Primary practice location
424 Savannah Rd
Lewes, DE 19958-1462
Mailing address
424 Savannah Road
Lewes, DE 19958-0226
Phone (914) 494-1975
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
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0068815 | DE | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1265122139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 SAVANNAH ROAD",
"city": "LEWES",
"state": "DE",
"postal_code": "199580226",
"telephone_number": "914-494-1975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 SAVANNAH RD",
"city": "LEWES",
"state": "DE",
"postal_code": "199581462",
"telephone_number": "914-494-1975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSMAN-LACKOW",
"first_name": "EDNA",
"middle_name": "ANNA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "DE",
"license": "L1-0068815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.