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BRIAN GLASS FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1396176202

Individual Registrant:
 BRIAN  GLASS FNP
Gender: M
Not Sole Proprietor

Location and contact information for practice:
20601 W. PAOLI LANE  WEIMAR, CA 95736 US
Tel: 559-797-0232  Fax: --

Contact information for business:
20601 WEST PAOLI LANE  WEIMAR CALIFORNIA, CA 95736-9755 US
Tel: 530-637-4025  Fax: --

Registration Information:
NPI: 1396176202
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CANP95005781

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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