Provider Demographics
NPI:1033246277
Name:GLENN, DEENA DESHAWNA (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:DEENA
Middle Name:DESHAWNA
Last Name:GLENN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5001 EAST PATRICK HENRY HWY
Mailing Address - Street 2:
Mailing Address - City:BURKEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23922-0427
Mailing Address - Country:US
Mailing Address - Phone:434-767-4922
Mailing Address - Fax:434-767-4935
Practice Address - Street 1:5001 EAST PATRICK HENRY HWY
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922-0427
Practice Address - Country:US
Practice Address - Phone:434-767-4922
Practice Address - Fax:434-767-4935
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician