Karen Thelma Glucksberg, NP
Individual provider Active NPI Nurse Practitioner · Kayenta, AZ
NPI 1720183080 · NPPES record last updated Aug 14, 2012
Key facts
- NPI
- 1720183080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP30001524 (WA)
- Practice address
- Hwy 160 163 Building Ka2010
Kayenta, AZ 86033-0368 - Phone
- (928) 697-4000
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30001524 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS PHS Naihs Kayenta Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30001524 | WA | Yes |
Addresses
Primary practice location
Hwy 160 163 Building Ka2010
Kayenta, AZ 86033-0368
Mailing address
PO Box 368
Kayenta, AZ 86033-0368
Phone (928) 658-3378
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060012 | Medicaid | AZ |
Other providers in Kayenta, AZ
- Sue Freeman
- Renee Fuller
- Susan C Garner
- Margaret Gebbia
- Anna Marie Geving
- Kristina Kay Gonzales-Wartz
- Wilson Audin Gonzalez Rodriguez
- Phillip Eric Gonzalez
- Myrna Phyllis Gorman
- Michele Grizzel
All providers in Kayenta, AZ · Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2012. 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.