Individual provider Active NPI

Catherine L Glidden, ARNP

  • Pediatric Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1891909123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2095842 Issued in FL
Practice address
2550 Jenks Ave
Panama City, FL 32405-4310
Phone
(850) 769-1481
Fax
(850) 763-2435
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2095842 FL Primary

Addresses

Primary practice location

2550 Jenks Ave
Panama City, FL 32405-4310

Mailing address

2550 Jenks Ave
Panama City, FL 32405-4310
Phone (850) 769-1481

Other identifiers 1

IdentifierTypeStateIssuer
2095842OtherFLARNP LICENSE

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

State licenses

LicenseStateTypeSpecialty
2095842FLMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891909123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054310",
            "telephone_number": "850-769-1481",
            "fax_number": "850-763-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054310",
            "telephone_number": "850-769-1481",
            "fax_number": "850-763-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDDEN",
        "first_name": "CATHERINE",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "2095842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "2095842",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.