Delores Glenn
Individual provider Active NPI Licensed Practical Nurse · Newberry, SC
NPI 1558788554 · NPPES record last updated Mar 27, 2014
Key facts
- NPI
- 1558788554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- P37952 (SC)
- Practice address
- 2111 Wilson Rd
Newberry, SC 29108-1603 - Phone
- (803) 321-2300
- Fax
- (803) 321-2300
- NPI assigned
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P37952 | SC | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P37952 | SC | Yes |
Addresses
Primary practice location
2111 Wilson Rd
Newberry, SC 29108-1603
Mailing address
2111 Wilson Rd
Newberry, SC 29108
Phone (803) 321-2170
Other providers in Newberry, SC
- Madelyn Garcia
- Allison Kyzer Gardner
- Andrea Nicole Getz
- Robersena Gibbs Praylow
- Emily Nicole Gilliland
- Grace Healthcare LLC
- Stacey Traylor Graham
- Gus Michael Gray
- John W. Green
- Rebekka Lynn Greenwalt
All providers in Newberry, SC · Licensed Practical Nurse in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.