Katrina Glenn, NURSE LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703118933 Issued in MI

Practice address

13929 Harper Ave
Detroit, MI 48213-3672

Phone

(313) 924-8702

NPI assigned

Mar 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1407557135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13929 HARPER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13929 HARPER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133672",
            "telephone_number": "313-924-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "KATRINA",
        "credential": "NURSE LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703118933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glendale Attendant Care Agency
• Danyiele Ellese Glenn, FNP
• Dewand Leshawn Glenn
• Jaanna Desiree Carmilla Glenn
• Karen Glenn
• Katurah Glenn
• Kimberley Glenn
• Kimberly Jan Glenn
• Mary K Glenn, SAC
• Pamalar Glenn, RN

• Licensed Practical Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.

Verify at the official NPI Registry.